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COPYRIGHT DEPOSIT 



HABITS THAT HANDICAP 



HABITS 
THAT HANDICAP 

THE EEMEDY FOE 

NAECOTIC, ALCOHOL, TOBACCO AND 

OTHER DEUG ADDICTIONS 



By 
CHARLES B. TOWNS 




FUNK & WAGNALLS COMPANY 

NEW YORK AND LONDON 
1920 



Copyright, 1919, by 
FUNK & WAGNALLS COMPANY 

[Printed in the United States of America] 
Published, December, 1919 



Copyright under the Articles of the Copyright Convention of the 
Pan-American Republics and the United States, August 11, 1910 



A 5 e 1 8 8 o 

FEB 



CONTENTS 

Chapter page 

Preface vii 

Introduction xi 

I. Habits That Hamper Success . . 15 

II. "Easy the Descent Into Hell" . . 26 

III. The Many Ways Men Poison Them- 

selves 39 

IV. How the Poisons Act .... 55 
V. Who Is Besponsible? 73 

VI. The Mind of the Addict ... 89 

VII. The Problem of Prohibition . . 101 

VIII. Why the Addict Needs Definite 

Treatment 117 

IX. Breaking Barleycorn's Bonds . . 126 

X. The Sheep and the Goats ... 134 

XI. Poisoning Nerves with Nicotine . 145 

XII. Lady Nicotine and the Younger 

Generation 168 

XIII. How to Kill the Scotched Snake . 181 

Appendix 197 

v 



PEEFACE 

Some years ago, Mr. Charles B. Towns came 
to me with a letter from Dr. Alexander Lam- 
bert and claimed that he had a way of stop- 
ping the morphia habit. The claim seemed to 
me an entirely impossible statement, and I 
told Mr. Towns so; but at Dr. Lambert's sug- 
gestion, I promised to look into the matter. 
Accordingly, I visited Mr. Towns's hospital, 
and watched the course of treatment there at 
different times in the day and night. I be- 
came convinced that the withdrawal of mor- 
phine was accomplished under this treatment 
with vastly less suffering than that entailed 
by any other treatment or method I had ever 
seen. Subsequently, I sent Mr. Towns several 
patients, who easily and quickly were rid of 
their morphia addiction, and have now re- 
mained well for a number of years. 

At that time I had the impression that the 
treatment was largely due to the force of Mr. 
Towns's very vigorous and helpful personal- 
ity, but when subsequently a similar institu- 
tion was established near Boston, I became 

vii 



viii PEEFACE 

convinced by observation of cases treated in 
that hospital that Mr. Towns's personality was 
not an essential element in that treatment. 
His skill, however, in the actual management 
of cases, from the medical point of view, was 
very hard to duplicate, and Mr. Towns gen- 
erously came from New York, when called 
upon, and showed us what was wrong in the 
management of cases which were not doing 
well. I do not hesitate to say that he knows 
more about the alleviation and cure of drug 
addictions than any doctor that I have ever 
seen. 

All the statements made in this book, ex- 
cept those relating to tobacco, I can verify 
from similar experiences of my own, since I 
have known and used Mr. Towns's method of 
treatment. 

I do not pretend to say how this treatment 
accomplishes the results which I have seen it 
accomplish, but I have yet to learn of any one 
who has given it a thorough trial who has 
obtained results differing in any considerable 
way from those to which Mr. Towns refers. 

The wider applications and generalizations 
of the book seem to me very instructive. The 
shortcomings of the medical profession, of the 
druggists, and those who have to do with the 



PEEFACE ix 

management of alcoholics in courts of law 
seem to me well substantiated by the facts. 
Mr. Towns 's plans for legislative control of 
drug habits also seem to me wise and far- 
reaching. He is, I believe, one of the most 
public-spirited as well as one of the most 
honest and forceful men that I have ever 
known. 

I am glad to have this opportunity of ex- 
pressing my faith and confidence in him and 
my sense of the value of the book he has 
written. 

Eichabd C. Cabot, M.D. 



INTRODUCTION 

Of all the habits that hamper success there 
is none so crippling as an addiction. It is 
the chain that binds soul and mind and nerv- 
ous system to slain ideals — a chain as tangible 
as the welded links which, of old, bound the 
murderer to the corpse of his victim. 

It matters not whether the addiction be to 
narcotics, alcohol, nicotine or hypnotics. The 
result is the same — varying only in degree 
and in the character of the symptoms devel- 
oped. The effect inevitably is to decrease 
efficiency, lower the mental and nervous tone, 
inhibit moral responsibility, and invite physi- 
cal depreciation, disease, and an earlier death. 

While primarily all these might be held to 
be problems for individual solution, yet, as a 
matter of fact, they are questions that vitally 
concern the entire social fabric. 

For their ramifications extend into every 
madhouse, hospital and charity institution; 
into every police-court and penitentiary in 
the land. Their results are manifested in the 
relations between every human being and every 

xi 



xii HABITS THAT HANDICAP 

other human being bound to him by ties of 
blood, love or law. 

There could not, in the very nature of 
things, be a clearer exemplification of the per- 
tinent question asked of old: "Am I my 
brother's keeper ?" — which automatically an- 
swers itself in the affirmative. 

We are our brother's keepers. We are re- 
sponsible for safeguarding his welfare, and for 
preventing him from being poisoned — either by 
himself or by others — with his consent or 
without it. 

Either through ignorance, carelessness, or 
callousness, we have dug the slippery-sided 
pit into which thousands, and scores of thou- 
sands, of these brothers and sisters — unstable 
as to nervous organization, and deficient in 
will-power, have stumbled. 

We, and we alone, are responsible for the 
laxity of law, the lack of protecting restriction, 
which besmears the traffic in narcotic and 
hypnotic drugs. And which, until the day 
before yesterday, sanctioned the sale of, and 
participated in the profits in, alcoholic liquors. 

We, and only we, are responsible for the 
fact that — except in three enlightened States 
in this Union — there is practically no restric- 
tion against the sale of tobacco and cigarets, 



INTBODUCTION xiii 

even to minors. Indeed, their sale might 
even be said to be encouraged by the most 
suggestive and constantly seductive appeal. 

Also, we have no one to blame but ourselves 
for the fact that, to date, the Federal Narcotic 
Law, regulating the sale of habit-forming 
drugs, has been a chief source of gratification 
to Belzeebub and his imps in hell. 

Up to this writing, the present supposed 
drastic laws, both Federal and State, looking 
to the regulating and prescribing of habit- 
forming drugs have proved a farce. 

These iniquitous laws, and their toothless, 
doddering enforcement, are the most promi- 
nent reasons why we have more victims of 
habit-forming drugs here in America than 
there are victims of tuberculosis. 

The fault is ours. In these pages we shall 
show why this fault is ours. And, having 
shown why, we shall indicate the remedy. 

For it is all very simple — and very obvious. 
It needs no seventh son of a seventh son, nor 
no ghost returned from the tomb, to point it 
out. 

But it does need sincerity, and honesty of 
purpose, to carry out the suggested methods 
of reclamation. 

If we can make up our minds to apply this 



xiv HABITS THAT HANDICAP 

sincerity and this honesty of purpose to our 
present problem, we shall have done the best 
and the most constructive work that has ever 
been done — not only for the rehabilitation of 
the addict, but also for the betterment of the 
entire human race. 

And this is a work well worth while. 

Edwist F. Bowers, M.D. 



Habits That Hamper Success 

There is considerable nrale in every man — 
and most women. We resent being forced to 
do — or to leave undone — the things that do 
not conform to our conception of what con- 
stitutes the line of least resistance. 

Were this not so, the profound wisdom of 
the philosophers, and the equally constructive 
advice of those who have bought their experi- 
ence with a bit of their lives, would not so 
frequently fall upon the sterile ground of our 
indifference. 

More of us would skirt the shell-holes, and 
the pitfalls, instead of waiting to locate them 
for ourselves — by the aid of broken mental, 
spiritual or physical bones. 

And yet, praise be, things are never quite 
so black as they might seem, at first sight. 
Especially when we remember that all our life 
is an education: and that everything we are 
and know is an accretion — built in us, as the 
pearl oyster builds nacre around a particle 
that otherwise might prove a source ox irrita- 

15 



16 HABITS THAT HANDICAP 

tion — even to the point of exciting a diseased 
process. 

We shed the habits of the savage with which 
we are born, and which are a heritage of the 
race. Year by year imitation, emulation, edu- 
cation, admonition — even discipline and pun- 
ishment — polish us, and bring out the luster of 
those acquired traits we class as attributes of 
civilization. 

If we are born free from the stigmata of 
degeneracy, and of normal nervous and men- 
tal reactions toward environmental conditions, 
we learn — by precept, by example, by uncon- 
scious absorption — what qualities are most 
helpful to the general good, and what char- 
acteristics are outlawed and taboo. 

"We learn that selfishness, carelessness and 
destructiveness react harmfully — even disas- 
trously — upon ourselves, and upon those whose 
good opinion we have come to value. Gradu- 
ally there is built up in the normal being an 
instinct — or even a strong consciousness — that 
these traits not only may cause distress and 
loss to others, but that even more certainly 
and effectively they may influence our own 
well-being. 

Similarly we find that apathy, indifference, 
laziness and inefficiency, while they may seem 



HABITS THAT HAMPEB SUCCESS 17 

to relieve us of certain responsibilities, add 
measurably to the responsibilities of others — 
frequently leading these others to the very 
substantial wall of " diminishing returns" on 
our account. 

If these others happen to be our employers, 
patients, clients, or customers, their reaction 
to these consequences and their causes may 
prove a salutary lesson to us — provided we 
are not' so blinded by egotism that the lesson 
rolls from our unbending backs, breeding at 
the same time an intensification of these faults 
— manifesting themselves in disloyalty, ingrati- 
tude, dishonesty and hatred. 

All these are traits that result from faulty 
training, a false viewpoint, or an ingrained 
spirit of combativeness. They may be eradi- 
cated by "taMng thought." They may be 
turned inside out by an effort of the will, or 
they may be made to serve a truly construc- 
tive purpose — as when hatred, cruelty and 
destructiveness are applied in war against the 
common enemy. 

But, in the last analysis, while these traits, 
developing by long-continued repetition into 
habits, are distinctly mental in their origin 
and in their development, their ultimate re- 



18 HABITS THAT HANDICAP 

suits are pathological, and baneful to the last 
degree. 

For the twisted and distorted mental out- 
look tends to twist and distort the processes 
of digestion, assimilation and metabolism. The 
conversion of food substances into finished 
organic material, and .the reduction of the 
"end products" into forms least harmful to 
the system and most favorable to elimination, 
is interfered with. 

Under the influence of fear, anger or hatred 
the alembic of the mind may turn mother's 
milk to worse than gall. Medical records show 
that not infrequently infants have died of 
acute toxemia after suckling a mother made 
furious by rage. 

The inhibiting action of anxiety and worry, 
and the piling up of horror upon horror all 
through those murky war-years, now happily 
past, has familiarized every physician in the 
civilized world with a picture of the reaction 
of this form of nerve tension. 

Commencing with .loss of appetite, or some 
form of digestive trouble, it has reflected itself 
in irritability, headache, sleeplessness, nervous 
exhaustion, neuritis, neuralgia, rheumatism, 
sciatica, lumbago, and generally lessened re- 
sistance to disease. 



HABITS THAT HAMPER SUCCESS 19 

The lack of normal nervous activity mani- 
fests itself also in torpor of the liver, in a 
decrease of the peristaltic action of the bowels, 
in the development of putrefactive intestinal 
conditions, and in the absorption of these 
toxic products into the circulation. 

Here they act as poisons, still further to 
lower the general nervous and muscular tone, 
still further to depress the general system, 
and still further to aggravate the already ex- 
isting trouble. 

Indeed, many able clinicians now contend 
that the real instigating cause of the devastat- 
ing plagues of influenza and pneumonia which 
swept the world during the last months of 
the war, was the decrease in vital resistance, 
due primarily to nervous depletion. 

Be that as it may, it is absolutely certain, 
and proved beyond a doubt, that mental in- 
fluences can, and do, so disturb normal meta- 
bolic processes that beneficent secretions are 
transformed into highly toxic substances, ex- 
ercising not only a depressive, but even a fatal 
action at times. 

Mental habits that are destructive in their 
nature, therefore, breed actual pathological 
conditions — conditions which not only may 
hamper success in the business, social or 



20 HABITS THAT HANDICAP 

domestic life of the individual, but may eventu- 
ally land him in the sanitarium — or even in 
a madhouse. 

So, these traits are not merely the vagaries 
of waywardness — peccadilloes to be condoned, 
or tacitly encouraged by complacently yielding 
to them. They are the beginnings of a pesti- 
lential condition, that grows by what it feeds 
upon — developing into an actual morbid state 
that may be incurable, except by definite medi- 
cation calculated to first rid the individual of 
all his accumulated poisons, and then build 
him up — bodily, as well as mentally. 

So certain am I of this that I confidently 
believe that every man, woman and child now 
confined in an asylum, or in a hospital for the 
insane, might be markedly benefited, and in a 
large percentage of cases restored to normal- 
ity, by a course of medical treatment which 
would "cleanse the stuffed bosom of that peril- 
ous stuff that doth weigh upon the heart.' ' 

This doe& not mean that congenital idiots, 
or those suffering from deficiency or some mal- 
functioning of the ductless glands, or from 
brain-tumor or pressure, or from the patho- 
logical deterioration of syphilis or brain soft- 
ening, can be normalized, or even improved 
by treatment. 



HABITS THAT HAMPER SUCCESS 21 

It does mean, however, that dementia prae- 
cox, melancholia, acute mania, delusional in- 
sanity, and all those forms of mental derange- 
ment due to shock, grief, worry, and other 
distinctly mental causes, can be materially 
helped and, in many instances, thoroughly 
restored by depoisoning the tissues and brain 
cells, and then rehabilitating these patients 
nervously and physically. 

A case which came to us recently illustrates 
admirably what I have here attempted to indi- 
cate. This young woman, the daughter of a 
prominent physician in a New England State 
had suffered a nervous breakdown from a too 
intensive application to her college work. She 
became morose and moody, developing at the 
time an intractable insomnia. 

And, by the way, sleeplessness is one of the 
most prolific of all causes for mental derange- 
ments, as the Chinese, with their fiendish 
methods of torturing criminals condemned to 
death, have proved. We know, from these 
experiences, that an unfortunate, continually 
prodded into enforced wakefulness, will either 
die, or go insane, within a week — or sometimes 
even less. 

As might be expected, this young woman 
received the usual treatment with hyocine and 



22 HABITS THAT HANDICAP 

other hypnotics, which had little effect upon 
the insomnia, but which measurably increased 
her mental incoordination. 

She became more and more deprest, develop- 
ing at the same time delusions of persecution 
and a tendency toward suicidal mania. 

Some of the most eminent alienists in New 
England advised, for her own safety, that this 
girl be committed to an institution. Her 
father, however, on my advice, insisted upon 
first trying a course of elimination. Without 
the loss of a moment's time the same de- 
poisoning treatment used with narcotic, alco- 
holic and tobacco cases was begun with this 
patient — and pushed vigorously. She re- 
sponded wonderfully. 

Within forty-eight hours the entire aspect 
of the case had changed for the better. With 
the clearing out of the system, and with the 
active stimulation of the glands and cells, the 
mind came out from under its morbid cloud. 

The girl's depression and melancholia were 
replaced by a cheerful optimism. Her natur- 
ally sunny disposition reasserted itself — her 
confidence and trust in her relatives and 
friends was restored. 

After a short period of unpoisoning treat- 
ment, and then a few weeks devoted to physi- 



HABITS THAT HAMPER SUCCESS 23 

cal reconstruction, the young girl was taken 
home — absolutely sound, physically and men- 
tally. 

So, unpoisoning the system may "minister 
to a mind diseased, and pluck from the 
memory a rooted sorrow. " The pity of it is 
that so obvious a measure of utility is not 
universally adopted and practised. However, 
while these mental and nervous reactions, de- 
pendent upon nerve strain, wrong thinking, 
and an erroneous attitude toward matters of 
fundamental human relationship, are intensely 
interesting — particularly to the student of 
psychiatry — I propose, in these pages, to con- 
cern myself more with matters in which, with 
some justice, I may claim to be an authority. 

I use the expression advisedly, because for 
upward of eighteen years I have been a pio- 
neer, blazing a trail in an unbroken wilderness 
of misconception of the causes, effects and 
treatment of toxic addiction. Without any 
precedent for guidance, I have developed a 
new philosophy in relation to habits that have 
degenerated into addictions. 

My work has obtained the recognition and 
the unqualified endorsement of such men as 
Dr. Alexander Lambert, Dr. Smith Ely Jel- 
liffe, Dr. Richard Cabot, of Boston, one of 



24 HABITS THAT HANDICAP 

the ablest of diagnosticians; Dr. Harlow 
Brooks, Dr. David Myerle, Dr. Samuel Lam- 
bert, Dr. Jacobi, and hundreds of men in 
every part of the world who stand in the 
very forefront of their profession and in its 
counsels. 

It is with these paramount questions of 
narcotic addiction — as they concern the happi- 
ness and welfare of the individual, the in- 
tegrity of the family, and the health and vital- 
ity of the race — that I feel I have a distinct 
message of help and hope. 

And it is largely for the reason that I 
believe in Humanity — that I recognize them 
as "gods, tho in the germ," that I want to 
give them the benefit of what it has cost me 
almost a young lifetime of study to find out. 

Men and women can be educated and led; 
they can not well be dogmatized and driven. 
Legislation may make it difficult for them to 
obtain one form of poison, but only education 
can make them will to do without poisons. 

If the individual can not be educated to see 
the evil of degenerating addictions, legislative 
enactment will only serve to drive him to sub- 
stitutes^ — perhaps even more insidious than the 
one of which he was forcibly deprived. 

And these substitutes are so balefully com- 



HABITS THAT HAMPER SUCCESS 25 

mon, so universally accessible, that we do but 
"scotch the snake" when we halt the sale of 
one habit-forming drug and leave the unstabil- 
ized addict to choose from among scores of 
others that lethal dose which takes the man 
out of manhood, poisons the well-springs of 
the race, and puts a handicap of nervous 
deterioration upon future generations. 



n 

"Easy the Descent Into Hell" 

Between the lowest-browed man and the 
highest-browed ape there is a deep, wide gulf 
that forever demarcates these two species of 
animals. It doesn't lie in the fact that the 
descendant of a Paleolithic Adam has an em- 
bryonic sonl concealed about him. For there 
are many splendid and loving dogs that have, 
and constantly show, far more of the true 
celestial spirit in a week than millions of 
erect-walking mammals do in a lifetime. 

Nor does it consist in the proudly recounted 
fact that a savage will replenish a dying fire ; 
while a savage ape, because he can not per- 
ceive the connection between combustibles and 
comfort, will let it die. For "civilized" apes 
have been taught to grasp this elemental law 
of cause and effect. They have developed suf- 
ficient of the Promethean intelligence to feed 
the flames, or to light the candle ; to say noth- 
ing about the achievements of some of them 
in the way of trick bicycle riding, dressing and 
undressing, using the eating tools of civiliza,- 

26 



"EASY THE DESCENT INTO HELL" 27 

tion, and conducting a fairly intelligent, tho 
necessarily limited, conversation. 

The difference is distinct from any of these 
qualifications. It consists in the apparently 
inherent and universal inclination of human 
beings — created a little lower than the angels 
— to get drunk, on occasion — or even more fre- 
quently, if the opportunity is propitious — while 
most animals cordially detest alcohol as a 
beverage. 

There are some exceptions among them, to 
be sure, but only enough to prove the rule — 
if exceptions ever do prove a rule. 

For instance, wasps, ants and bees — who 
have many pugnacious and ferocious instincts 
in common with man — take advantage of the 
development of fermentative changes in over- 
ripe fruit juices to lay the proper foundations 
for a Bacchanalian orgy. 

Through theif indulgence in these ferments 
they become humanly intoxicated — quarreling 
wildly and excitedly — finally ending their 
revels by crawling away in a semi-somnolent 
condition to sleep off the effects of their cele- 
bration. Some hens and chicks will also de- 
vour bread soaked in whisky or brandy with 
relish and gusto. 

And occasionally, elephants and dogs may 



28 HABITS THAT HANDICAP 

acquire a fondness for liquors. Some degen- 
erate dogs will drink beer and refuse meat 
when both are offered at the same time. 

But aside from these few instances in which 
the taste for liquor has been more or less culti- 
vated by degenerative training, our furred, 
haired, and feathered friends furnish us an 
example that might point a moral and adorn 
a tale — if we cared enough' about morals and 
tales to philosophize upon them. 

So in some respects we are considerably 
lower than the higher animals — and always 
have been. For, from those dawning days of 
the childhood of the race — perhaps even be- 
fore the rudest written symbol for the inter- 
change of thought was devised, — the fermen- 
tative mash of a calabash of fruit punch was 
drained as, hundreds of centuries later, the 
wassail bowl, the tankard, and the brimming 
wine-cup have been emptied — for its intoxi- 
cating effects. 

No race so low in the scale of intelligence, 
none so primitive and elemental in its com- 
plex of life, nor none so close to the demi- 
god in point of physical and mental develop- 
ment, but has resorted to some form of nar- 
cotization — as naturally, and with as little 
effort, as a duck takes to water. 



"EASY THE DESCENT INTO HELL" 29 

It has never seemed to matter much what 
the effects of the narcotic were, just so long 
as they substituted for the prosaic and the 
monotonous, or for the grunt and grind of 
life, a brief respite, an oblivion, even most 
temporary. 

Whatever was accessible was utilized — alco- 
hol, opium, hasheesh, the fumes of petroleum, 
tobacco — anything and everything that altered 
the point of mental contact and changed the 
man's nervous relation to the world. And 
whether for better or for worse was not of 
so much consequence as that there should be 
a change. 

This state of dependence upon a narcotic 
or stimulating drug, and, more particularly, 
the state of body engendered by the drug it- 
self (for the poisoned body is even more in- 
tractable to deal with than is the poisoned 
mind) constitute perhaps the most crippling 
and hampering condition that can come to any 
human being. 

For there is no longing or emotion equal 
in intensity to that of a drug user for his 
drug. It fastens itself like the tentacles of 
an octopus about its victim, shackling body and 
soul in a desperate bondage. 

For narcotic or stimulating drugs mothers 



30 HABITS THAT HANDICAP 

will sell the children of their flesh, men will 
murder, and women will barter their bodies. 
I have had under my care clergymen of the 
very highest moral character, who have be- 
come shoplifters and forgers, through the de- 
basing influence of alcohol or drugs. I have 
treated shrewd, successful business men, who 
have been dragged down into pauperdom be- 
cause their enslaving habit had left them at 
the mercy of sharpers after mental deteriora- 
tion had set in. 

Eepeatedly I have seen exemplary wives 
lose every sense of moral responsibility, as 
the result of the inhibiting action of some 
habit-forming drug upon the higher brain- 
cells. 

For, remember, it is the cells of latest devel- 
opment in the biological scale, the cortical 
cells, that are the first to become obsolete in 
function through the effects of drugs, as has 
repeatedly been proved by scientists studying 
mora! degeneracy in those afflicted with soft- 
ening of the brain. 

Therefore, the moral and the ethical devel- 
opment—the latest of the traits evolved by the 
socialization of human beings — are the first 
to be lost through the disintegrating influences 
of addiction. 



"EASY THE DESCENT INTO HELL" 31 

Nor does drug addiction confine itself within 
any boundary line. Every stratum of society, 
from the palace on Fifth Avenue or Beacon 
Hill to the slums of State Street or the Bar- 
bary Coast, furnishes its quota of victims to 
that grim Over-Lord, King Druggery the 
Great. 

The delicate, refined society woman, and the 
half-animal gangster — waiting for the lethal 
clutch of that grim chair behind the little green 
door; the charming, college-bred matron, and 
the thick-lipped son of a slave-woman — 
scarcely more intelligent than a trained 
ourang — all pay the tribute of their souls' life 
to the parasite growth of drug addiction. 

With the narcotic drugs, in particular, the 
craving is most insidiously acquired, for it is 
only human nature to attempt to gain even 
temporary surcease from the agony of the 
throbbing nerve or the dead-weight of the 
aching heart. 

Hardly a normal adult, in the throes of 
pain, or in the deep gulch of sorrow, or pros- 
trated by fatigue, who is not likely, in a 
moment of least resistance, to avail himself 
of the effects of an easily accessible opiate or 
stimulant. 



32 HABITS THAT HANDICAP 

And the most sinister feature of the pos- 
sessing action of these drugs is that even the 
smallest dose, capable of producing the re- 
sults for which it is taken, if repeated with 
sufficient regularity, is quite as potent for 
harm as would be a much larger dose, less 
frequently taken. 

One, for instance, who would use an eighth 
of a grain of morphine three times a day 
would acquire the morphine habit just as 
surely as would the man who might use three 
grains of morphine three times a day, — pro- 
viding this individual could tolerate morphia 
in this quantity. 

Take the opium smoker as another example. 
The " hop fiend" consuming twenty-five "pills" 
a day gets only the morphine equivalent of a 
quarter of a grain of morphia taken hypo- 
dermically, or of a half grain taken by the 
mouth. A novice in the art, or crime, of 
opium-smoking could not consume even a quar- 
ter of this quantity of drug. And yet the 
beginner acquires the opium habit, and in a 
few months he is as firmly enslaved as tho 
he had been a life-long devotee. So any 
amount of any drug which is sufficient to re- 
lieve pain or to stimulate the user to feel 
"different," is sufficient to create a craving 



"EASY THE DESCENT INTO HELL" 33 

for the continuance of the drag that gives this 
relief or this stimulus. 

Not infrequently, the enslavement to a drug 
habit manifests itself in an incredibly short 
period. Only recently, I treated a case of 
morphine addiction in a man who had been 
taking the drug barely five weeks. He had 
suffered rather severe pains from a broken 
leg, for the relief of which hypodermics of 
morphine were prescribed. 

During this brief time he developed one of 
the most aggravated cases of morphine addic- 
tion I have ever seen. He was quite as com- 
pletely unstabilized, and required quite as 
definite a course of treatment as did another 
most unusual case, treated at almost the same 
time, who had been taking the drug for nearly 
fifty years. 

There is a great misconception also in the 
mind of the average man and woman — a mis- 
conception cunningly built up and nurtured 
by vendors of drug-containing nostrums — that 
the combination of their favorite poison with 
some relatively harmless ingredients neutral- 
izes the toxic effects of the poison. 

Nothing could be further from the truth. 
For it does not matter in the slightest, so 
far as toxicity or habit-forming qualifications 



34 HABITS THAT HANDICAP 

are concerned, how the drug may be disguised, 
nor how it may be combined with other drugs 
designed to alter its taste or its physical 
aspects. 

It is the saturation of the tissues by the 
drug-toxins, and the organic and nervous 
reaction to these toxins, that works the evil. 
It is the drug itself, and not its combination 
in medicine, in snuff, in atomizer solution, or 
in suppository, that does the harm. Even tho 
the drug be combined with its physiological 
antidote, atropine, the habit-forming effects 
are quite as certain as tho the "straight" drug 
were used. 

So no combination which allows the physio- 
logical effects of the drug to become manifest, 
is less injurious, or less habit-forming, than 
would be the drug itself taken alone. This is 
true of every "elixir," "cough medicine," 
"tonic," "sedative," "narcotic," or " hyp- 
notic " — no matter how prettily panelled their 
container, how beautifully they may be col- 
ored, or how pleasantly they may have been 
made to taste. 

Indeed, it is quite likely that the more ap- 
pealing these "medicines" are to sight and 
taste, the more frequently the dose can be 
repeated, and the larger the quantity toler- 



" EAST THE DESCENT INTO HELL' > 35 

ated without exciting Nature's defense of 
nausea against the poison. 

In fact, were it not for this natural de- 
fense, unfortunately operative in only a small 
percentage of cases, the victims of opium and 
its derivatives would be even more numerous 
than they are. 

It is this sickening effect alone that has 
saved many from the habit. For this type 
of user never experiences any of the tempo- 
rarily soothing or dream-exciting sensations 
which commonly follow the use of the drug. 
The only effects the opiate has for him is to 
make him wish he were dead. 

Yet this pitiful, natural safeguard, while 
rarely operative, is more efficacious in pre- 
venting addiction than any other that up to 
the present has been provided by man in his 
heedlessness, indifference and greed. 

It is curious, also, that women, tho consti- 
tutionally more liable than men to feel the 
need of medicines, and by habit and example 
more prone to indulge in medicine-taking than 
men, form, by far, the lesser portion of the 
drug-taking class. 

Except among the women of the under- 
world, the introduction of women to the drug 
habit is due almost exclusively to the use of 



36 HABITS THAT HANDICAP 

some drug combination, first administered in 
perfect good faith by a physician. 

Tho the use of drugs is almost universal 
among the immoral and criminal, it must not 
be inferred that all addicts are necessarily 
immoral or criminal. Many are of the highest 
moral character — in the beginning. How long 
they may remain so is another question. Drugs 
are the common tragedy of the professional 
world — of doctors, lecturers, actors, writers, 
scientists, teachers, or students — of all those 
who snatch at doubtful relief from the penalty 
of overwork, as well as of mere sensation- 
seekers, or of those who are attempting escape 
from violation of moral law. 

Perhaps the most pitiable fact connected 
with the use of drugs is the extreme youth 
of a majority of the addicts. Narcotics are 
peddled sometimes within one hundred feet of 
a schoolhouse, and boys and girls of from 
fourteen to eighteen become enslaved to their 
effects. It is a matter of statistics that a vast 
majority of those using these poisons in New 
York and adjoining states are' between the 
ages of sixteen and twenty-one. 

In fact, one City Prison Physician, testify- 
ing before the Senate Public Health Commit- 
tee a few years ago, made the startling asser- 



"EASY THE DESCENT INTO HELL" 37 

tion that within a radius^ of a few blocks of 
Third Avenue and 149th Street, New York, 
more than one thousand school children had 
acquired the heroin habit, or were in danger 
of becoming " joy-riders" because of their use 
of the drug. 

The profits on these drug sales are enor- 
mous. Any figure between three hundred and 
three thousand per cent, may represent the 
gain acquired by these debauchers of young 
lives. 

The " doped drink," furthermore, is the 
most potent ally of the white-slaver, for in 
the intermission between dances much is ac- 
complished through the agency of a drugged 
drink that may never be undone. 

It is the "American type" of individual, 
however — highly nervous, constantly living 
under pressure, always going to the full limit 
— or even beyond — who is most prone to physi- 
cal or nervous disorders that lead to the 
habitual use of drugs. 

A surprizing number of us are hypochon- 
driacal by nature, prone to "take something" 
when we feel badly. And so it is mighty 
fortunate for many that a lack of knowledge 
of what to take, and a lack of opportunity to 
secure the poison, stands between us and drug 



38 HABITS THAT HANDICAP 

addiction. Were it not for this fortunate ig- 
norance there would be infinitely more drug 
addiction in this country than there now is — 
and heaven knows there is a-plenty. 

For it is conservatively estimated that 
there are now in America approximately a 
million and a half victims of habit-forming 
drugs alone — not to mention the devotees of 
rum, headache powders, ether, and flavoring 
extracts. 

Probably 2 per cent, of all practising phy- 
sicians, and thousands of nurses and druggists 
are •addicted to narcotics. And the ranks of 
the drug victims are being added to at the 
rate of an additional hundred thousand new 
recruits every year. 

There is no more serious problem confront- 
ing the constructive intelligence of our law- 
makers, our philanthropists, and our phy- 
sicians to-day than the regulation of this soul- 
and-body-destroying traffic — this traffic that 
makes easy the descent into hell. 

To deal adequately with this criminal com- 
merce is a matter that must concern every 
man and woman who feels any natural re- 
sponsibility for the welfare of their fellows 
— and for the protection of the generations 
that are to come. 



ni 

The Many Ways Men Poison Themselves 

We are now consuming more habit-forming 
drugs than all Europe combined. Our con- 
sumption of opium is far greater, per capita, 
than that of China, long looked upon as the 
worst of all drug-sodden countries. And this 
was true even of the China of pre-Eepublic 
days — those glad days of only a few years 
back, when the myriads of opium pipes were 
cast into the devouring flames by the enthusi- 
astic and celebrating heathen. 

Since 1860 there has been an increase of 
300 per cent, in the importation and consump- 
tion of opium in all its forms in America, as 
against only 133 per cent, increase in popula- 
tion. During the past ten years there has been 
an annual importation and consumption in 
America of four hundred thousand pounds of 
opium, 57 per cent, of which is' made into 
morphine. 

It is estimated that 80 per cent, of this 
morphine is used by victims of the morphine 
habit. Some authorities place the figure even 
higher, claiming that only 10 per cent, of 

39 



40 HABITS THAT HANDICAP 

all opiates are used legitimately for blunting 
pain. The other 90 per cent, are employed by 
drug habitues for the purpose of murdering 
their best instincts and their physical well- 
being. 

In addition to opium and all its derivatives, 
one hundred and fifty thousand ounces of 
cocaine are used illicitly. 

And still further to swell the total, hundreds 
of pounds, or even tons, of other hypnotics, 
narcotics and nerve-deadening drugs are used. 

We have dug for ourselves this deep and 
slippery-sided pit, to fall into which is as easy 
as lying. But once in, there are few, indeed, 
who climb back to the bright light of normal- 
ity again without a soul-chastening struggle. 

The most dangerous of all habit-forming 
drugs are opium and its derivatives; cocaine, 
and the hypnotic group — trional, veronal, sul- 
phonal, medinal; and other sedatives derived 
chiefly from coal-tar sources. Of late years 
the abuse of bromides and other nerve 
"soothers" has also been greatly on the 
increase. 

These hypnotics and sedatives are not usu- 
ally classed as habit-forming drugs. Yet their 
effects are almost as destructive, and the 
toxemias they engender quite as definitely 



HOW MEN POISON THEMSELVES 41 

pathological as are the effects of opium or 
alcohol, and for these reasons their sale should 
be regulated quite as scrupulously as should 
be the sale of the more generally recognized 
narcotics. 

I have never seen more pitiable cases than 
those who come to me after they have been 
taking regularly, over a considerable period of 
time, some "cure" for sleeplessness. For 
this habit not only produces an extreme neu- 
rotic condition, but it also changes the entire 
temperament of a person. It will turn the 
most beautiful character into an extreme case 
of moral degeneracy. 

Again, most of us have peculiar idiosyn- 
crasies with regard to certain drugs. I have 
seen patients who could not take as much as 
two grains of veronal or trional without flush- 
ing, itching, or similar symptoms. With such 
people large doses might bring about serious 
results — or even death. 

I have treated scores of victims of bromides, 
chloral, and the "sleeping powder" habit, and 
I can not too strongly emphasize that the 
victims of these delectable forms of "dope" 
are quite as unstable, and equally as difficult 
to reconstruct, as are those who long have 
been abusers of alcohol, opium, or cigarets; 



42 HABITS THAT HANDICAP 

And, further, the sale of these hypnotics, 
without a prescription, is inviting a serious 
risk. For how is it possible for a man, be he 
ever so well qualified as a pharmacist, to know, 
for instance, that an amount of veronal which 
would not ordinarily affect a child might cre- 
ate an intense nervous disorder in a particular 
type of adult? 

Yet the sale of hypnotics, of almost any 
type, is unrestricted in this country. Prepa- 
rations intended for the relief of "nervous- 
ness" and insomnia are widely advertised, and 
openly and energetically sold. Yet they are 
all definitely dangerous in character, and defi- 
nitely habit-forming in their action. 

Opium and its alkaloids are the chief nar- 
cotic drugs with which we have to deal in this 
country, altho extracts of hemp and other 
mind-destroying drugs have a tremendous 
vogue among certain Eastern peoples. 

Opium and its alkaloids are unique in re- 
spect to the fact that no other drug can be 
satisfactorily substituted for them — once tol- 
erance is established. Chemists have given 
us more than twenty different salts or alka- 
loids of opium — under as many different trade- 
names. To each of these preparations they 
have ascribed glowing virtues. If one were 



HOW MEN POISON THEMSELVES 43 

to believe what these German gentlemen tell 
us, the impression would be inescapable that 
each new-found pet opiate was> in the same 
class with baby-foods for harmlessness and 
beneficent worth. 

All of which would be very interesting and 
important, except for one thing: there isn't 
a word of truth in any of the statements. 
For anything that has an opiate's action is an 
opiate — no matter by what sweet-smelling 
name it may be called. The harmless dis- 
guises are intended, in the end, only to de- 
ceive. And, until it is possible to extract 
from fire its burning qualities, or from water 
its wetness, it will be equally impossible to 
extract from opiates their opiate qualities. 

Morphine is the chief active principle of 
opium. It is intrinsically, in its insidious 
effects, far worse than opium itself — for opium 
has certain inherent properties which partly 
counteract the evil effects of the morphine it 
contains. 

The morphine user generally retains his 
faculties. He is usually capable of intelli- 
gent conversation. He is able to discuss the 
various phases of his condition — something 
which is quite impossible with a victim of the 
alcohol habit. 



44 HABITS THAT HANDICAP 

Codeine and heroin are the most important 
derivatives of morphine. Codeine, while it is 
only one-eighth the strength of morphine, is, 
nevertheless, decidedly habit-forming in its 
action. 

Doctors have been led to prescribe it quite 
freely as a sedative in cough, and for the 
relief of pain, as well as for its hypnotic 
effects, notwithstanding the fact that it is the 
accumulative consequence of continued small 
doses, and not the quantity of morphine in 
each dose, which may, and does, develop an 
addiction. 

For to use any narcotic drug effectively 
means, in the long run, the necessary increase 
of the drug up to the limit of physical tol- 
erance. 

Heroin, which is the basic element of "cure" 
in many liberally advertised expectorant mix- 
tures, is three times the strength of morphine. 
It was first introduced to the world by the 
indefatigable German chemists — the name 
"heroin" being merely a trade name. 

It was announced as being a morphine de- 
rivative, in which the highly depressing effects 
of the morphine were eliminated, while the 
stimulating effects of the morphine were re- 
tained. 



HOW MEN POISON THEMSELVES 45 

Of late years this highly toxic product has 
supplanted morphine and codeine in the pre- 
scriptions of many physicians, particularly in 
cough and asthma mixtures. It is a baleful 
and dangerous drug to rely upon, particularly 
in those long-standing pulmonary conditions 
that may get well, only to leave behind them 
a nervous system unstabilized and fettered in 
the bonds of a habit which makes life far 
more wretched for its victim than the disease 
it has supplanted. 

The grim joke in connection with heroin is 
that this powerful opium alkaloid was origi- 
nally, and by some physicians still is, thought 
to be quite harmless. Indeed, in many cases, 
where it was given by prescription, heroin was 
ordered by the physician in the sincere belief 
that it would not create a habit. 

Yet, a patient, accustomed to taking three 
grains of morphine daily, can be made com- 
fortable on a single grain of heroin, and will 
not suffer so much as from the depressing 
effects of taking the morphine "straight." 

I may mention here that I was the first 
to give the medical profession the clinical find- 
ings on this drug in comparison with morphine 
and other preparations of opium. 

I told the profession at the time that it was 



46 HABITS THAT HANDICAP 

the most harmful of all the derivatives of 
opium, and that, in view of its extreme stimu- 
lating effects, a tolerance of the drug would 
be more quickly established than by the use 
of the opiate in any other form — an observa- 
tion which experience has proved to be true. 

For heroin takers acquire the habit quite as 
quickly and easily as tho they had been using 
morphine. I have had repeatedly to treat 
cases of heroin addiction in which the victims 
have thought to satisfy their needs for an 
opiate without forming a habit. 

Physicians generally do not yet know how 
long a drug may be administered, nor how 
much may be taken, before a tolerance for the 
drug is set up. Indeed, this point would be 
extremely difficult to determine. For each 
patient has his own limit of resistance, to 
ascertain which it is necessary to let him 
proceed to this limit. Having proceeded to 
this point, however, he is definitely and com- 
pletely within the thralldom of the opiate. 

There is, of course, only a palliative effect 
in any of these drugs, since, like opium, they 
have no curative power whatsoever. 

Cocaine is the most harmful of all habit- 
forming drugs. There is nothing that so 
quickly undermines the constitution, or that 



HOW MEN POISON THEMSELVES 47 

provides so direct and expeditious a road to 
the insane asylum. 

A man does not acquire the cocaine habit 
in the sense that it is virtually impossible for 
him to leave it off without medical treatment. 
He can, if he will, relinquish it, altho he rarely 
does, because of the fact that, on withdrawal, 
he experiences only an intense and horrible 
depression, associated with a prostrating 
physical languor, which results in a sleepiness 
that can hardly be shaken off. 

It is just the reverse in this respect from 
opium withdrawal, which causes a distressing 
insomnia, together with an extreme nervous 
and physical irritability. 

In its action, too, cocaine is exactly the op- 
posite of opium; for cocaine stimulates amaz- 
ingly, whereas opium usually soothes and 
quiets. 

While the stimulus of cocaine wears off 
rapidly, it nevertheless confers half an hour 
or more of capability for intense effort. This 
isi why bicycle riders, prize-fighters and race 
horses are often " doctored' ' with cocaine. 

When the effect of the cocaine gives out its 
victim usually resorts to alcohol for stimulus. 
Alcoholics, when deprived of alcohol, almost in- 
variably drift into the use of morphine. 



48 HABITS THAT HANDICAP 

The widespread use of cocaine among the 
laity in the comparatively short period* of 
time since its discovery and its introduction 
to this country has undoubtedly been brought 
about by the use of patent medicine prepara- 
tions, containing small quantities of the deadly 
drug. These have been chiefly the so-called 
"catarrh, cures " — a type of remedy which, of 
course, never cured anything. 

Yet, with only a 2 or 4 per cent, solution 
of the drug, these " cures' ' brought about a 
craving for cocaine which made "repeat sales' ' 
a certainty, and which started thousands down 
that steep path that leads to the labyrinth of 
murdered hopes. 

As with other habit-forming drugs, in order 
to gain the desired result, the dose of cocaine 
must be increased in proportion to the gradual 
increase in physiological tolerance. 

Cocaine contracts and deadens the tissues 
with which it is brought in contact, and this, 
in the case of catarrh, relieves instantly the 
discomfort, making one feel, for the time, as 
tho there were no nose on one's face. Its 
effect, however, lasts only for twenty to thirty 
minutes. 

This is one of the reasons why the cocaine 
habit is so readily formed. A man, taking 



HOW MEN POISON THEMSELVES 49 

any powerful stimulant, is certain to feel a 
corresponding depression when the effects' of 
this stimulant wear away. It thus becomes 
necessary for him to take more of the drug, 
in order to be buoyed up and restored again 
to the point of normality. 

It is among these "accidental" cocaine 
users, therefore, not the yearning for any 
abnormally pleasant sensation which sends 
them back again and again to their dosage, 
but merely their desire to be measurably re- 
stored to the comfort which is habitual to the 
normal state. 

It must be apparent, however, that as soon 
as it has become necessary for any one to 
resort to the use of a drug in order to rise 
to the normal, that there has been a marked 
depreciation, physical and mental — or prob- 
ably both. 

This explains the fact that so many crimi- 
nals are to be found among cocaine users. 
For no drug so quickly brings about mental 
and physical deterioration. 

Also, cocaine is the most expensive of all 
the drug habits. I have known victims who 
habitually used 120 grains a day, at a cost of 
about seventy dollars a week. 

This is undoubtedly one important reason 



50 HABITS THAT HANDICAP 

why so many have been made criminals and 
prostitutes by the use of cocaine. One who 
uses it diminishes his- earning capacity ; while, 
on the other hand, one who must have it must 
have money, and a considerable quantity of 
it in order to continue his habit. 

Perhaps it is the matter of expense which 
explains why the underworld has taken so 
avidly to heroin instead of cocaine. Heroin is 
so much cheaper. 

Whenever the sale of the poison has been 
restricted to those presenting a physician's 
prescription, the consumption of cocaine has 
immediately been lessened, for most men can 
not afford a doctor's prescription for a patent 
medicine — and no reputable physician would 
write one, unless neuralgia, or some equally 
painful condition demanded the use of this 
powerful agent. 

We have become so thoroughly accustomed 
to the use of headache powders and the se- 
ductive "fizzy" drinks containing acetanilid 
as a pain club, that we consistently ignore the 
depressing effects these drugs may have upon 
the heart, and their deleterious results upon 
the blood — breaking down its red corpuscles 
and creating serious and persistent anemias 
thereby. 



HOW MEN POISON THEMSELVES 51 

Indeed, familiarity has bred in us an easy 
contempt of analgesics. So to-day there hardly 
exists an apothecary, no matter how honest 
and conscientious, who will not undertake, for 
a consideration, to recommend a headache 
remedy, of whose action he knows nothing, for 
a headache the cause of which he knows less. 

Without the slightest knowledge of the pa- 
tient's idiosyncrasies, he will prescribe for him 
blithely and cheerfully, taking never the slight- 
est thought as to whether the mixture he sells 
may not be absolutely contra-indicated by rea- 
son of some organic condition. 

To the average druggist a headache is only 
a headache — just as the yellow primrose, grow- 
ing by the river's brink, a yellow primrose was 
to the gentleman Tennyson talks about — and 
nothing more. 

Yet no physician would, without a careful 
examination, assume the responsibility of pre- 
scribing for a man who came to him complain- 
ing of pain. For what might alleviate one 
form of headache might be disastrous in the 
headache produced by another variety of 
toxemia — to say nothing of the fact that any 
headache should be removed by removing its 
cause, and not by bludgeoning it into insensi- 
bility with a dose of dope. 



52 HABITS THAT HANDICAP 

And there is also the possibility of killing 
the patient suffering from a lack of informa- 
tion, complicated by a too-abundant supply 
of headache powders. In one case, brought to 
my attention, a girl, in attempting to relieve 
an obstinate headache, which probably would 
have been most quickly corrected by an enema, 
had taken nine headache powders, all within 
an hour. 

Had there been ten minutes delay in sum- 
moning a doctor, she would have died. As it 
was, she escaped only by the narrowest of 
margins — and for a long time afterward was 
most seriously ill. 

Preparations of the nature of Bromo-Seltzer 
— and other coal-tar products notable for pro- 
ducing anemia and nervous depression — are 
undoubtedly responsible for the presence of 
many men and women in the mad-houses of 
the land. 

These "remedies" disturb the digestion; 
they interfere with natural sleep; almost in- 
variably they must be used in increasing 
quantities, as the system becomes accustomed 
to their use ; and quite without exception they 
are excreted by the kidneys, thus throwing an 
additional burden upon organs perhaps already 
badly overworked. 



HOW MEN POISON THEMSELVES 53 

The chemist who first evolved the happy 
idea of including caffeine in these preparations 
has been instrumental in putting millions of 
dollars into the pockets of the manufacturing 
druggists; and he has also been instrumental 
in saddling the world with a great and entirely 
unnecessary weight of physical and mental 
degeneration. 

It must be remembered that only a very 
powerful drug can stop a headache as quickly 
and completely as Americans have come to 
demand. The preparation must be sufficiently 
potent to deaden disordered nerves, and being 
chosen because it is generally effective, not 
selectively effective — as would be the case with 
a remedy chosen after an intelligent diagnosis 
had revealed the real nature of the trouble 
to be treated — it is virtually certain to have no 
curative properties whatsoever. It is unde- 
niable that hundreds of deaths have resulted 
from unwisely experimenting with such prepa- 
rations. 

The time will come — and it should be here 
now — when the prescribing of hypnotic and 
analgesic drugs will be in the hands of men 
trained to know when to avoid them. And 
their sale without responsible sanction will be 
prohibited by law. 



54 HABITS THAT HANDICAP 

Alcohol and tobacco are such well-known and 
justly celebrated poisons that their considera- 
tion is of sufficient importance to warrant 
of their treatment in a separate chapter. 

The former bids fair to be relegated to what 
one of our ex-presidents, for want of a more 
expressive term, designated as "innocuous 
desuetude' ' some years back. 

The latter promises to remain in our midst 
for some time to come. Altho, judging by 
the attitude of three of our progressive west- 
ern States and by the increased activity among 
those who object to being poisoned by proxy, 
it is quite likely that Lady Nicotine will some- 
time, perhaps within the lifetime of men not 
yet bald, be sent to consort with old John 
Barleycorn. 

For the good of everybody concerned, let 
us hope this may come to pass. While she 
might be missed by many, her going would 
relieve, not only men, but numberless women 
and little children of one of the most insidi- 
ous, complete and certain means- of thoroughly 
and completely poisoning themselves. 



IV 

How the Poisons Act 

While the general effect of any of the habit- 
forming drugs is to change the mental and 
physical "feelings" of the one who takes 
them, and while possibly 90 per cent, of all 
the drugs that are used are employed pri- 
marily for this purpose, yet there is a wide 
variation in the action of these drugs. 

Some produce deep sleep, or even uncon- 
sciousness — associated with the most marvel- 
ous and enchanting dreams — or else horrible 
nightmares — of the Kublai Khan variety. 

Others produce a wild delirium of exhilara- 
tion, a frenzy of sexual desire, or a maniacal 
sadistic tendency, culminating in the actual 
shedding of blood — as with the hasheesh- 
crazed Malay who runs amuck, slashing right 
and left with his murderous creese, until he 
is stopt by a bullet. 

Other drugs produce the most exhalted 
visions, as with ether or naphtha inhalation, 
or with ether drinking. 

55 



56 HABITS THAT HANDICAP 

Still others produce a cheerful, contented 
stupor, as with some of the hypnotics and, to 
a certain extent, with tobacco. 

None who have read DeQuincey's intensely 
interesting, even tho highly colored, "Confes- 
sions of an Opium Eater," can fail to be 
imprest with the avenues of mental adventure 
which the indulgence in a drug may open up. 
And yet, DeQuincey's reactions toward opium 
are not duplicated by one in a hundred drug 
takers. 

After all is said and done, the average drug 
addict, wittingly resorting to drugs, first does 
so because he is neurotic and unstable, be- 
cause he is suffering from ennui, or because 
he has an inherent desire to get drunk — to 
satisfy which desire he takes the means that 
lie closest to hand, or that make the greatest 
appeal to his imagination. 

The effects of toxic drugs, however, in pro- 
ducing definite pathological changes in his 
organism, are not of the imagination. They 
are, on the contrary, as distinct and definite 
as is a broken leg, or a case of eczema. 

For they are brought about by a material 
agency — the accumulation in the system of 
small quantities of the drug to which he may 
be addicted — together with a saturation of 



HOW THE POISONS ACT 57 

the tissues by the toxins developed by the 
inhibiting action of the drug. 

It is in the nature of opiates to deaden what 
is known as the osmotic function — that process 
by which the millions of cells in the body 
absorb nutriment through their walls from the 
blood with which they are constantly sur- 
rounded; and also by which they get rid of 
their used-up material through a reversal of 
the process. 

These two processes— known as anabolism, 
or "building up," and katabolism, or "break- 
ing down," if interfered with, result in a dis- 
turbance of metabolism, and this in turn, may 
actually cause — or else predispose to — almost 
anything and everything that can happen to 
abnormalize the human body and mind. 

This explains why the deprivation treat- 
ment, and every other treatment for these 
addictions, which is not directed toward elimi- 
nating these inhibiting poisons and toxins from 
the system, is so generally foredoomed to 
failure. 

I can never too strongly reiterate that any 
form of treatment designed to relieve drug, 
alcohol, or tobacco addiction, must include in 
its scope the thorough and radical depoison- 
ing of the system. 



58 HABITS THAT HANDICAP 

The most prominent symptom of the drug 
addict — any kind of a drug addict — is his crav- 
ing for his drug. Each drug, however, has its 
own peculiar complex. 

For instance, opium addiction, in any form, 
is usually associated with irresolution, lack of 
self-control, a tendency toward moral ob- 
liquity, and a total loss of all regard for the 
truth. 

Toward the time when another dose of the 
possessing poison is due there is quite fre- 
quently pain in the regions of the stomach, 
sometimes associated with intense nausea, 
altho whether this is real or feigned is some- 
times difficult to determine. 

Mental depression is a much more constant 
symptom, usually associated with insomnia, 
restlessness, marked anxiety, and a sense of 
impending evil — all of which are, for a time, 
relieved by the dose. 

The glandular secretions and the elimina- 
tive functions of the body being hampered in 
their activity, there is usually an obstinate 
constipation present — altho this may be alter- 
nated with aggravated attacks of diarrhea. 

A famous novelist, who has had fourteen 
years of disastrous experience with a wife 
addicted to paregoric, alcohol and cigarets, 



HOW THE POISONS ACT 59 

sums up the symptoms of drug addiction some- 
what as follows: 

If your husband, wife, brother, sister, friend 
— let us call this person "he," for conveni- 
ence's sake — if this person complains of aches 
and pains, usually in the back or chest, and if 
his skin itches, and he likes to have his back 
rubbed and scratched, think of morphine. 

If he has the habit of going somewhere 
regularly, at about the same hour every day, 
making excuses to absent himself, and getting 
uneasy if prevented, bear in mind the peri- 
odic dope craving that drives the victim to the 
source of supply almost like clockwork. 

If he steals from you, and especially if he 
lies, suspect dope. If he is blue, morbid and 
despondent, always ' i knocking ' ' everything 
and everybody, giving everything a pessimis- 
tic, mean turn, remember that dope makes 
people this way. 

If he is thin and emaciated, constipated, 
sallow and cold, suspect dope. Also, if cross, 
argumentative, obscene, thick-tongued, whin- 
ing. If he thinks everybody is against him, 
and is convinced that there is a conspiracy 
on to injure him, don't forget dope. 

If he is mentally dull, irritable, and without 



60 HABITS THAT HANDICAP 

appetite and energy; if he sweats at night; 
if he is evasive and will not look you in the 
eye; if he lacks will-power and is unreliable, 
suspect dope. 

If, above all, his eyes look varnished, and 
the pupils remain contracted at night, or in 
artificial light — " pin-point pupils" — then be 
almost sure of dope. This is the most im- 
portant symptom. Taken in connection with 
three or four of the above, it ought to consti- 
tute a positive proof. Don't forget the "pin- 
point pupil!" True, one method exists of 
camouflaging this, and of so expanding the 
pupil, even while morphinism is present, as to 
deceive the unwary. This is by the use of 
belladonna, or its active principle, atropine. 
But not many opium-users seem to know, or 
care to use, this method of avoiding detec- 
tion. 

My novelist friend concludes: "If you sus- 
pect, or know, that some one dear to you is 
the victim of morphine, opium, codeine, pare- 
goric or laudanum, don't accuse. You will get 
no confession; you will get nothing but lies. 

"Don't appeal to the will-power of the 
patient, and leave him at large. In most 
cases he has no will-power; and as long as 
he is at large, he will get his drug. Consult 



HOTT THE POISONS ACT 61 

a doctor, and have the patient properly 
treated." 

All of which is extremely sane, practical 
advice, as- well it might he, being bought with 
the very heart's blood of the novelist, and 
some of the best years of his life. 

The symptoms of paregoric or laudanum 
addiction, morphine, heroin, codeine, or any 
other of the opium derivatives, are all similar 
— varying only in degree, and in some minor 
detail of expression. 

Cocaine, however, is a drug the action of 
which is almost invariably exhilarating. In 
fact, this constitutes* its most insidious appeal. 
It lends to the mentally distraught a sense of 
security. It makes the most sanguine of 
dreams appear true. The negro " snowbird' ' 
(as "coke" fiends are sometimes called) takes 
a little sniff, and straight is transported to a 
banquet hall in which chicken is the piece de 
resistance. The poverty-stricken become, for 
the period of their trance, millionaires. The 
sick think themselves sound, and to the normal 
man or woman taking this drug, the world 
seems a splendid place for an indefinite so- 
journ. All men are brave and noble, and all 
women beautiful and true. 

Among the educated, the intoxicated, drug- 



62 HABITS THAT HANDICAP 

projected spirit thunders at the doors of high 
Olympus, flouts Jove, and makes merry with 
the Fates themselves. 

The psychological effect of cocaine is per- 
haps its most conspicuous and pernicious fea- 
ture. Cocaine habitues are almost without 
exception notorious liars. Their moral sense 
is destroyed in proportion to their subjection 
to the habit. Their faculty of knowing right 
from wrong is atrophied and shriveled. In 
the matter of appeasing their drug-engendered 
appetite, they are absolutely without scruple. 
They will steal, even murder, if necessary, to 
obtain their stimulant. 

The sensations following the use of cocaine 
vary slightly, according to the individual. The 
exhaltation, which is its first effect, may, and 
frequently does, take the form of wild frenzy, 
sometimes accompanied by the fantastic hal- 
lucinations and delusions that are associated 
with acute mania. This is followed by pro- 
found depression, and frequently a sensation 
as of worms or insects beneath the skin, and 
sometime ocular and circulatory disturbances 
— all of which furnish the all-compelling pre- 
text for continuing the use of the drug, or for 
attempting to overcome temporarily the thing 
that overcomes it. 



HOW THE POISONS ACT 63 

Occasionally the addict imagines that certain 
people are abusing or persecuting him, and 
this incites his murderous attack upon unsus- 
pecting and entirely innocent victims. This 
is particularly true of the negro in the South, 
whose nervous organism is very unstable when 
excited by drugs. He becomes a veritable 
fiend, lusting for blood. Thus cocaine is re- 
sponsible for many terrible tragedies in the 
South. 

The sniffing of cocaine by the negro is an 
important cause of the alarming increase in 
crimes against women in the South. The stim- 
ulating and exciting effects of the drug trans- 
form its victims into satyrs. And the pitiful 
part of it is that they are no more responsible 
for their bestial acts when under the influence 
than is a tiger for killing, or a snake for 
striking. 

This country is rapidly awakening to the 
perils of permitting the cocaine habit to de- 
velop further, and stringent measures are now 
urged to stamp out the evil. That the prob- 
lem is one of extreme difficulty can be appre- 
ciated when it is recalled that an ounce of 
cocaine, and an amount so trifling that it can 
be carried in the smallest pocket of a man's 
clothes, is sufficient for one thousand average 



64 HABITS THAT HANDICAP 

doses. This amount is rarely exceeded in a 
month by the largest dispensing pharmacists 
in their legitimate prescription work. But it 
is ample to keep fifty "fiends" thoroughly 
doped for a week. 

It would be stating the matter conserva- 
tively to say that for every ounce employed 
legitimately, there are two hundred ounces 
consumed illegitimately. 

Indeed, the ease with which cocaine or he- 
roin are administered is one of their most 
dangerous attributes. To get definite results 
with morphine, it is necessary to have an 
elaborate outfit, consisting of a hypodermic 
syringe, and of a liquid solution of the drug, 
or a spoon in which to dissolve it. The inser- 
tion of the needle, too, is a painful process, 
and not seldom are the punctures infected, 
forming disagreeable abscesses. 

"With cocaine or heroin, however, no appa- 
ratus is necessary. A small portion of the 
powder is poured on the back of the hand, 
or blown from a powder insufflator. A quick 
sniff, and the drug efhct is secured. 

Bather peculiar is the fact that the cocaine 
taker, in contradistinction to the morphine, 
heroin, acetanilid, or chloral user, is gregari- 
ous in his tendencies. He joys in seeing others 



HOW THE POISONS ACT 65 

in a condition similar to his own. He re- 
sembles a convivial drunkard in this respect. 

In many parts of the country the practise 
of giving " snuffing parties' ' is common, and 
these are likely to be followed by an orgy of 
murder. So when an overseer in the South 
will deliberately include cocaine in the ration- 
ing of his negro laborers, in order to speed 
them up to meet emergency demands, it is 
high time that more adequate legislation re- 
stricting the sale of cocaine should be effected 
than obtains under the present hemiplegic 
Federal Narcotic Law. 

Our old friend, Alcohol, is another degen- 
erating influence. He is probably the most 
ubiquitous and harm-producing agent in or out 
of captivity. The chief pathological action of 
this protoplasmic poison is strikingly shown 
when the leucocytes — the white cells in the 
blood that defend us against the attacks of 
invading micro-organisms — are subjected to 
its influence. 

Under the microscope it is demonstrated 
that even a moderate quantity of alcohol ab- 
sorbed into the blood paralyzes these phago- 
cytes. They behave like drunken sots; they 
can't move fast enough to catch the disease- 
germs, and when placed in the midst of a 



66 HABITS THAT HANDICAP 

clump of malignant microbes are unable to 
kill and devour them. 

In the chronic alcoholic the microscope dem- 
onstrates that the fighting powers of the white 
corpuscles are permanently reduced. This 
accounts for the lowered vitality of heavy 
drinkers — and to a lesser extent of any drinkers 
— and explains why pneumonia, typhoid, or 
grave infectious diseases are so fatal among 
them. 

In fact, after continued heavy drinking, the 
microscope reveals that the phagocytes have 
not only lost their real nature, but that they 
have returned to a condition of savagery, and, 
instead of defending their host and his body 
cells, they have become degenerate cannibals, 
feeding upon the tissues and organs like dis- 
ease germs. 

The favorite food of these alcoholized cor- 
puscles is the tender cells of latest develop- 
ment, the highest and most delicate in the 
biological scale. These are the brain cells. In 
proof of this, the presence of the gray' matter 
of the brain can be demonstrated in the 
bodies of the leucocytes of drunkards. This 
explains mental degeneracy among these un- 
fortunates. 

But, in addition to paralyzing the phago- 



HOW THE POISONS ACT 67 

cytes, alcohol has three other methods of help- 
ing along the fair cause of degeneracy. The 
first centers in its fat-dissolving qualities. 
For alcohol has a much higher affinity for 
fat than an Esquimo has for blubber. Be it 
remembered that all fat-dissolving substances 
are narcotics; and furthermore, the facility 
and rapidity with which they dissolve fats 
determine their power as narcotics. 

Thus, ether or chloroform, dissolving fat 
more rapidly than alcohol, are stronger nar- 
cotics than alcohol, altho their effects are 
more transient, and therefore less disastrous. 

But alcohol also has an affinity for oxygen. 
It combines with oxygen to form an aldehyde 
(one of the steps toward the dissolution of 
alcohol into its elements). This oxygen hun- 
ger causes alcohol to rob the blood of its loose 
oxygen. This retards normal oxidation of 
food products, and causes the accumulation of 
effete and under-oxidized material. These 
products act as actual organic poisons upon 
the nerve cells and tissues — preventing their 
active functioning. 

Alcohol has an especial fondness for water, 
which it seems to like much better than the 
man who drinks it. In its sense-deadening 
progress through the system it robs the tissues 



68 HABITS THAT HANDICAP 

of this fluid. This accounts for the horrible 
thirst which follows hard upon the " morning 
after.' 9 The headache which usually accom- 
panies this same condition — it may be interest- 
ing to know — is due to increased blood ten- 
sion, to absorption of toxins, and to the con- 
gestions "reflexed" from the highly irritated 
stomach and alimentary tract. 

These, however, are but surface manifesta- 
tions. It is not in transient effects that the 
dull alcohol flood leaves its imprint, but in the 
degenerative changes which take place in the 
brain and nerve cells. 

All poisons have an u elective affinity" for 
special organs or tissues. Inasmuch as the 
brain and nerve cells are composed largely 
of fat, oxygen, and water, and as alcohol, by 
its principle of dissolving fats, combining with 
oxygen and abstracting water works its insidi- 
ous will with all three, we can readily under- 
stand, on a purely physiological basis, why a 
drinker should be wit-stricken. 

When the fat is dissolved out of the brain 
and nerve tissue, it paralyzes their cell func- 
tion. This paralysis is, at first, only tem- 
porary, clearing up with the sobering process. 
But if the cause is repeated sufficiently often, 
the paralysis becomes chronic, and dementia, 



HOW THE POISONS ACT 69 

acute insanity, tremors, palsy, and various 
other brain and nerve diseases develop. 

Paraldehyde, which is gaining a widespread 
use among the laity in the treatment of in- 
somnia, is a powerful habit-forming drug, 
which gives rise to symptoms similar to those 
produced by alcohol. 

It causes anemia, emaciation, weakness and 
irregularity in the heart action, derangement 
of the stomach and bowels, a general tremor — 
especially of the tongue, hands, and facial 
muscles. In addition, it produces the unsteady 
gait of the drunkard, restlessness and anxiety, 
mental excitement, and confusion and loss of 
memory, incoherence of speech, delusions and 
hallucinations, and delirium tremens. Paral- 
dehyde utterly unfits a man for the conduct 
of his business, and altogether it is one of the 
most insidious of our modern addictions. 

Another habit which is reducing the effi- 
ciency of the American public, and which is 
marvelously increasing their already plethoric 
stock of nervousness, is the use of chloral as 
a sedative and hypnotic. 

Victims of the chloral habit suffer from 
digestive disturbances, violent attacks of diar- 
rhea, unsightly skin eruptions, profound weak- 
ness of both mind and body, tremor, shortness 



70 HABITS THAT HANDICAP 

of breath, and heart irregularities. They con- 
stitute some of the most difficult and intract- 
able cases with which we have to deal. 

The use of cannabis indica, while not so 
common in America as in the East, is still of 
sufficient gravity to warrant consideration 
here. This extract of Indian hemp furnishes 
the famous hasheesh, which, in turn, furnishes 
the Malay his incentive for murder. 

Canabis indica is a most insidious drug, be- 
cause the intoxication it produces is usually of 
a highly agreeable nature — characterized by an 
intense mental and physical exaltation, to- 
gether with a marked increase in sexual desire. 
The habitual use of the drug, however, inevit- 
ably produces mental impairment, sexual im- 
potence, digestive derangements and anemia. 

The administration of bromides for any con- 
siderable period of time causes a depression 
of the nervous system, which absolutely inca- 
pacitates a man or woman for any intensive 
work. The abuse of this form of sedative is 
criminally common, as there are practically 
no restrictions upon the sale of the drug. The 
use of bromides over any extended period of 
time is quite frequently followed by complete 
sexual impotence, and occasionally by an ob- 
stinate and disfiguring skin eruption. 



HOW THE POISONS ACT 71 

We have already seen something of the 
disturbing effects upon metabolism exerted by 
headache powders and the coal-tar derivatives 
in general. But that Bromo-Seltzer and some 
of the other pleasantly disguised headache 
" remedies" will create a definite habit almost 
as marked as the craving engendered by ve- 
ronal, trional, and the hypnotics, is not gen- 
erally known. 

It is a fact, however, that thousands of 
neurotic men and women make a practise of 
helping themselves to a glassful of efferves- 
cent "joy" about every so often, actuated by 
no need save the need developed in their 
nervous systems by the accumulative action 
of the poisonous ingredients of these so-called 
remedies and by the irritating effects of the 
retained toxins of mal-metabolism, effects 
which are temporarily overcome by taking a 
little of the hair of the dog that bit them first. 

It is passing strange that man, created in 
the image of Grod, should knowingly and wil- 
fully put into his stomach or into his blood 
that which serves to steal away his brain, his 
moral concept, and his physical vigor. But 
such is the lamentable fact. And a fat, com- 
placent fact is one of the most obvious sore- 
thumb experiences in life. This is the grim 



72 HABITS THAT HANDICAP 

action of alcohol on the cells — the action which 
explains the mental and physical deteriora- 
tion of an alcohol addict. Its modus operandi 
for producing social, moral, and ethical degen- 
eration will be considered in a later chapter. 



Who Is Eespostsible? 

It is natural in the average Iranian being to 
want always to blame something or some one 
for his own shortcomings, defects or vices. 
It is a survival of the ' ' 'Twas the woman that 
tempted me to eat of the apple' ' principle. 

This is one of the most mischievous traits 
that has ever been handed down to men by 
the ignorance of the ages, and is particularly 
true of those afflicted with drug or alcohol 
addiction. For it has made arrant cowards 
of thousands and scores of thousands of men, 
who might otherwise be inclined boldly to face 
and conquer their degrading obsession. 

Now, I want to go on record, once and for 
all time, to the effect that — all the old grannies 
in the world to the contrary notwithstanding 
— there is no such thing as inheriting the 
alcohol or the drug habit. 

A man's father and mother — and all his 
relatives, back to Brian Boru or Julius 
Caesar — might have been drunkards, or opium 
smokers, or cocaine snuffers. But this doesn't 

73 



74 HABITS THAT HANDICAP 

constitute the slightest reason in the world 
why the man himself must inevitably be a 
drunkard, a "hop fiend/ ' or a cocaine user. 

For the drug addiction, like any other ad- 
diction, is an acquired trait. And acquired 
traits can not be transmitted. 

I know the statement of this fact will cause 
acute mental discomfort among many who 
have made their family and friends and them- 
selves believe that the unovercomeable and 
most grave and reverend reason for their 
excessive indulgence was because their father 
or grandfather transmitted the "hankering" 
for the poison to them. 

But there is, in science, absolutely no basis 
of justification for such a claim. 

This does not mean, however, that a man 
may not inherit an unstable nervous system 
from ancestors who had systematically poi- 
soned their organisms. A man who has a 
father whose cells were thoroughly saturated 
with "booze" and tobacco, could, and prob- 
ably would, inherit a defective nervous sys- 
tem. But he could not inherit a craving for 
drugs or drink. 

So get into the mind of the alcoholic or the 
habitue, as soon as you can, and with all the 
force of which you are capable, that it is his 



WHO IS EESPONSIBLE? 75 

own lack of nervous stability, and not the 
skeleton hand of some dead and gone ancestor, 
that points him to the road of alcoholic or 
narcotic addiction. For no matter how much 
alcohol or drugs his ancestors may have used, 
it is impossible for him to be inoculated by 
them with a craving for these poisons. 

If the man drinks or uses 1 narcotics, he does 
so because he wants to, and because he has 
poisoned his cells; so that they continually 
cry out for more of the stuff that is poisoning 
them — as is their nature. 

It is a matter of fact that, in ninety fami- 
lies out of one hundred any one who looks 
with sufficient diligence — and most alcoholics 
can be trusted to do this — can find just such 
an excuse for his own weakness. In thousands 
of instances even physicians have taken seri- 
ously such excuses offered by their patients. 
But the doctor who listens sympathetically to 
his patient's babble of heredity is sure to be 
misled; while the patient who believes this 
too-commonly accepted theory robs himself of 
his strongest weapon against his addiction — 
his own conviction of his personal responsi- 
bility and power for self-help. 

I am not minimizing the fact that certain 
alcoholics seem foredoomed to drink to excess 



76 HABITS THAT HANDICAP 

because their highly nervous organisms crave 
the excitation which alcohol confers-, because 
they do not get enough to eat ; or because they 
do not assimilate their food; or because their 
tissue cells cry out for fuel. 

Others still become alcoholics because 
through the help of stimulants they have 
habitually forced themselves to overwork, to 
bear burdens of responsibility beyond their 
normal strength, or to overcome poor health, 
eye-strain, grief or anxiety. 

These people may be physically or mentally 
abnormal. But they do not suffer from l i alco- 
holic disease" as such. For the records of 
my hospital work show that where a patient 
with an alcoholic history has been scientif- 
ically and medically treated for alcoholism, the 
definite removal of the craving for alcoholic 
stimulants is just as effective in his case as 
in the case of a patient who has no trace of 
alcoholic taint in his family. 

Further, I can show from our case records 
and clinical notes, that in the cases in which 
such a patient, through weakness, relapses into 
taking stimulants, he never charges that the 
source of his weakness is a craving for them. 
The urge may have been psychics 1 — business 
troubles, a quarrel with his wife — or what not 



WHO IS BESPONSIBLE? 77 

— - but it was not alcoholic craving, per se. 

I want also to emphasize, with all the con- 
viction of which I am capable, that there is 
no such thing as an " alcoholic disease.' ' 
There are diseases engendered by alcoholic 
poisoning — there are degenerative conditions 
of both mind and body, brought about by 
alcohol — but there is no such thing as the 
"disease of alcoholism." 

The alcoholic is a sick man. But he is sick 
because of alcohol. He is not alcoholic be- 
cause of an inherent psychosis which impels 
him to the use of alcohol. Another thing: 
the alcoholic, mentally weakened by the reac- 
tion of the stimulant, usually ready to shift 
the blame for his conduct from himself, is 
chronically afflicted with a craving for sym- 
pathy. Mothers, fathers, wives and friends 
grant him not only pity, but even tolerance 
to this state of mind, instead of knocking the 
psychologically harmful props from under him 
and making him stand on his own feet. 

Now, the only extent to which a man can 
be alcoholically diseased is the extent to which 
he has been taking alcohol in such quantities 
and with such regularity over a certain period 
that he has established a definite tolerance. If 
he has been taking the drug in sufficient 



78 HABITS THAT HANDICAP 

amounts this tolerance would mean, in the 
end, that if he were suddenly deprived of his 
stimulant delirium tremens and all the un- 
favorable consequences that might come out 
of this condition would result. 

Delirium tremens is a disease; alcoholic 
insanity is a disease; but these are due to 
nothing more or less than alcoholic poisoning. 
If the man be medically unpoisoned, he can 
not experience any of these diseased condi- 
tions. Nor can the unpoisoned alcoholic have 
any physical or mental craving for alcohol. 

Further, if he has been drinking moderately 
or occasionally, and the period of his present 
debauch is not too long extended, his alcohol 
can be stopt without fear of harm of any kind 
whatsoever. 

Sickness, worry, unhappy circumstances of 
every sort must be eliminated as excuses for 
alcohol or drug indulgence. If they are not, 
the victim of these addictions, altho he may 
gain for a time the mastery of his besetting 
sin, will presently be certain to furnish himself 
with an excuse justifying his return to it. 
Then will come a new downfall, more difficult 
to retrieve than the previous one. 

If anything could produce a drug disease, 
or a hereditary craving for a drug, it would 



WHO IS KESPONSIBLE? 79 

seem that it should be manifested in an infant 
born of a drug-taking mother, and doped with 
a narcotic, from the very day of its birth. 

Yet there is, among the records of my hos- 
pital, just such a case — the child being now 
perfectly normal as regards her desire for the 
drug. Her mother, who had taken, literally, 
gallons of laudanum long before the birth 
of this child, as well as afterward, was brought 
to me for treatment, together with her young 
child, whom, with the depravity characteristic 
of laudanum-users, she had systematically 
plied with the drug. 

Mother and child were both treated in the 
same room, and both made a splendid recov- 
ery from their narcotization. And without 
any subsequent desire upon the part of either 
to relapse into their former addiction. 

So, in the final analysis, it is the victim him- 
self who, knowing the habit-forming effects of 
any narcotic drug, wilfully uses this agent. 

In those instances, however, — and unfortun- 
ately there are scores of thousands of these 
in which the drug has been administered with- 
out the knowledge of the addict — the responsi- 
bility for the development of his tolerance 
must rest with the one who first administered 
or who first supplied him with the drug. 



80 HABITS THAT HANDICAP 

In this respect a great army of drug-takers 
have never been properly safeguarded from 
forming the habit, much less properly helped 
in overcoming it. 

The average physician, for one thing, has 
never realized* how easily drug addiction may 
be established, and so, in perfect good faith, 
physicians have administered opiates for the 
relief of pain or discomfort, which pain or dis- 
comfort it might have been possible to relieve 
in other ways. 

Still the patient naturally associating his 
relief with the means taken to relieve him has 
persisted in the use of the opiate when pos- 
sibly it was no longer necessary. This is 
particularly true if this suggestion of relief 
happens to be associated with the use of the 
hypodermic. Conservative physicians are so 
keenly aware of this possibility that some of 
them go so far as never to carry a "hypo" 
on their visits, even tho daily observation 
shows that the average doctor considers the 
instrument indispensable. 

Yet that it is not indispensable is proved 
by the fact that two of the busiest and most 
successful doctors of my acquaintances have 
used as little as a half a grain and two grains 
of morphine, respectively, in an entire year. 



WHO IS BESPONSIBLE! 81 

Both these men are convinced that only a 
small percentage of drug habitues have begun 
their practise because of some serious ailment 
demanding narcotic relief. And they are also 
convinced, as I am, that even this small per- 
centage might have been markedly decreased 
had more attention been paid to treating the 
cause of the condition rather than its tem- 
porarily painful symptoms. 

For it is only natural that the man who 
takes an opiate, consciously or unconsciously, 
and receives from it a soothing or stimulating 
or pleasant effects, turns to it again in case 
of the same need. 

The time soon arrives when the pleasurable 
part of the effect ceases to be obtained. So, 
in order to gain the soothing or stimulating 
effect, the dose must be constantly increased 
as toleration increases. 

With those who take an opiate to blunt a 
pain which can be removed in no other way, 
the drug is fulfilling its legitimate and su- 
preme mission. It admits of no substitute. 
Where it was ever physically necessary, and 
that necessity still continues, an opiate would 
seem to be inevitable. But the percentage of 
such sufferers, as I have said, is small. The 
overwhelming majority of drug addicts are 



82 HABITS THAT HANDICAP 

impelled to their addiction simply by craving 
— that intolerable craving that arises from 
deprivation of the drug. 

Pure, unadulterated ignorance is often re- 
sponsible for the development of narcotic addic- 
tion. I remember a case of a young girl of fifteen 
or sixteen, employed to "mind" the child of a 
newspaper woman, whose work kept her away 
from home many evenings every week. 

This " nurse-girl/ ' — not vicious or a drunk- 
ard, or immoral, but with merely the young 
girl's love of a "good time" — through some 
means or other, found that a few drops of 
laudanum would quiet a crying baby and put 
it to sleep for several hours. 

So, knowing nothing of the harmful effects 
of the "dope," she adopted the practise of 
giving the baby left in her charge a little 
tincture of opium every night. After which 
she was free to go to the "movies" or to 
some little gathering. 

It was only because of the increased fret- 
fulness and growing emaciation of the baby, 
together with the clear-headedness of the fam- 
ily physician, that the truth was finally dis- 
closed. It required a regular course of de- 
poisoning treatment before this infant was 
once more restored to normality. 



WHO IS BESPONSIBLE? 83 

Possibly there are many of such cases 
every year in various parts of the country — 
and will be, as long as paregoric and other 
poisons are sold openly. 

It is for these reasons, I contend, that 90 
per cent, of the opiates used in this country 
are, strictly speaking, unnecessary. In the 
thousands of cases that have come under my 
observation, 75 per cent, of the habitual users 
fall into the evil without reasonable excuse. 
Beginning with small occasional doses, they 
were gradually swept into the white waters 
of the maelstrom of addiction. 

Yet, while any one can go into most drug 
stores throughout the United States and buy 
paregoric, it can readily be understood that 
upon the laxity of the law which permits this 
practise there can legitimately be charged a 
damning responsibility. 

Paregoric contains 46.5 per cent, of alcohol 
and 1.9 grains of opium to the fluid ounce. 
A "shot of booze" that would satisfy the most 
exacting toper, and a dose of morphine equiv- 
alent to that usually given a normal adult ! 

Yet the sale of this product comes within 
the law that permits the traffic in "remedies" 
that do not contain more than "2 grains of 
opium; or *4 grain of morphia; or % grain 



84 HABITS THAT HANDICAP 

of heroin; or 1 grain of codeine; or any salt 
or derivative in one fluid ounce liquid, or one 
avoirdupois ounce of solid or semi-solid prepa- 
ration." 

Cough mixtures and "anodynes" containing 
these dangerous habit-forming drugs are sold 
indiscriminately, practically without let or 
hindrance, under the mercy of a law that pro- 
tects the self-sacrificing manufacturers of 
doped patent or proprietary medicines in their 
exploitation of a poisoned public. 

In fact, the extent to which the manufacture, 
sale and use of many so-called "patents" and 
"proprietaries" are responsible for the growth 
of drug-addiction is even yet not understood. 
Yet these preparations are all dispensed 
within the law. They are part of the regular 
stock in trade of every drug store, and are 
sold in the regular course of business with 
perfect legal propriety 

Yet case after case could be cited where the 
taking of opiates began with the taking of 
proprietary medicines, sold freely under the 
present law over the counters of drug stores 
without a physician's prescription. 

The patient goes to a druggist and gets 
something for headache, neuralgia, insomnia, 
a troublesome cough, or rheumatic or gouty 



WHO IS EESPONSIBLE? 85 

trouble. The "something" he gets contains 
just enough narcotic to relieve the pain, and 
so the man or woman comes back regularly 
for more. Thus addiction is established; 
for, as we have seen, drug addiction is fixt, not 
by the quantity of the drug taken, but by the 
regularity with which a quantity, however 
small, is taken for a period long enough to 
establish tolerance and fix the habit. 

Confirmed drug habits have also grown out 
of the use of "diarrhea mixtures" containing 
certain small quantities of opiates that can 
be prescribed and sold by the druggist in any 
quantity. I have trustworthy knowledge of 
the fact that when the Harrison Narcotic Law 
went into effect, a confirmed opium-taker in a 
Connecticut village, finding that she would 
have difficulty in getting her accustomed sup- 
ply of drug, went to her apothecary in great 
distress. 

She learned from him that paregoric would 
produce the results her system had come to 
demand. She experimented with one bottle 
of paregoric, and finding it satisfactory for 
her purposes, immediately purchased all the 
paregoric the druggist could sell her — no less 
than eight gallons! 

Since the passage of the law requiring the 



86 HABITS THAT HANDICAP 

express statement of any dangerous ingredi- 
ents in a compound' — a law originally designed 
to protect the public against habit-forming 
drugs — the sale of these preparations has in- 
creased with plague-like rapidity throughout 
the country. 

So it seems a just inference that the infor- 
mation given, instead of serving as a warning 
to the unwary, has been chiefly effective in 
pointing out the dangerous path to those who, 
without this gratuitous help, would otherwise 
have never known where to find it. And, lest 
it be thought that this devastating increase in 
drug consumption has been due to increase in 
population, or to increase in immigration, let 
me emphasize the fact that the immigrants 
are not drug-takers. Among the thousands of 
addicts whom I have treated or known, I have 
never seen an Italian, a Hungarian, a Eussian 
or a Pole. Moreover, I have met with only 
four cases of drug-taking among Hebrews. 
Pew Jews, except in the underworld, acquire 
the habit knowingly. It may become fastened 
upon them through the use of a medicine, the 
danger of which they did not realize. But 
once freed they do not again come under its 
sway. The practical sagacity of their race 
is their surest safeguard. 



WHO IS KESPONSIBLE? 87 

Nor is the addiction to habit-forming nar- 
cotics a problem that is confined to America 
alone. London, which is not even threatened 
with a curtailment of its alcoholic beverages, 
has the same evil to combat. 

Only recently, for instance, a young actress, 
a popular music-hall singer, died as a result 
of an overdose of cocaine. Investigation de- 
veloped the fact that she had no intention of 
committing suicide, but that the drug was 
obtained by her regularly. As a result of 
this and numerous other cases, English author- 
ities have conducted raids which have uncov- 
ered a regular criminal traffic in cocaine. 

In our own city of New York the Supervis- 
ing Internal Eevenue Officer instituted a raid 
in which two hundred drug victims, six physi- 
cians and four druggists were caught, while 
a fortune in narcotics was seized. 

It was estimated that these six physicians — 
as busy a pack of male Borgias as ever went 
unhung — had written 500,000 prescriptions for 
morphine, cocaine and heroin within a few 
months. 

One physician had the names of more than 
three thousand addicts in his prescription 
blank-books — men and women sold into the 
most abject of all forms of slavery. For- 



88 HABITS THAT HANDICAP 

tunately there are only a few out of many 
thousands of medical men who stoop to this 
worst of all forms of moral pandering. It is, 
however, to the credit of the great mass of 
the medical profession that they have kept 
their skirts free from this contamination. 

And yet the situation is grave. It demands 
careful consideration and a drastic weeding- 
out of all these degenerating influences, for 
it is essentially a medical problem. 

In view of all these facts, and in view of 
the further fact that the situation is rapidly 
growing no better, all the various interests 
concerned must be brought to cooperate to 
lessen this evil. 

In no other way is it possible to fix the 
responsibility and to correct an iniquity which 
is, perhaps, in all the history of the world the 
most debasing and degrading that has ever 
been perpetrated by man on his brother man. 



VI 

The Mietd of the Addict 

The average alcohol or drug-addict is the 
most obstinate and unreasonable of all mam- 
mals. For the prayers and pleadings of an 
habitue's wife or mother, the tears of his 
sweetheart, the threats of his employer, the 
punishment of a magistrate, are alike inef- 
fective, in the vast majority of instances, to 
work in him the miracle of reformation. 

The alcoholic addict, in particular, is in an 
abnormal mental and physical condition. He 
is a sick man, with an inflamed brain — that 
kind of a brain that leads to everything in this 
world that is not worth while — including his 
own moral and ethical deterioration. And 
before anything constructive can be done for 
him, he must, if possible, be made normal 
again — by definite medical means. 

In one respect alcoholics are much more 
hopeless than the average drug fiend, for the 
drug-addict's demoralization is usually not 
nearly so complete as is that of an alcoholic. 
And at least one-half of the world's chronic 

89 



90 HABITS THAT HANDICAP 

alcoholics have syphilitic histories — something 
which can not be said of drug habitues — lax 
tho many of them are in point of morality. 

This is inevitable for the reason that the 
alcoholic is usually susceptible to the advances 
of any woman whatsoever, without regard to 
race, color, previous condition of servitude, 
or present condition of cleanliness — and, as 
a rule, devotes less than the normal attention 
to his own wife. 

To set out to reclaim a chronic alcoholic is 
most always, therefore, to undertake to re- 
form a man who has been crippled morally 
and mentally, as well as physically. 

But it is not in his sexual life alone that the 
alcoholic shows deterioration. He demon- 
strates his shortcomings also in a loosening 
of the sense of moral obligation and in the 
inevitable development of absolute irresponsi- 
bility. Avoidance and neglect of customary 
duties, evasion of new ones, extraordinary 
resourcefulness in the discovery of the line 
of least resistance and, finally, amazing cun- 
ning and treachery in all his dealings — this 
is the sordid progress of the alcoholic. 

The immediate action of morphine is not 
nearly so inhibiting upon the mental faculties 
as is the action of alcohol. Under the sway 



THE MIND OF THE ADDICT 91 

of opium, however, a man does venturesome 
or immoderate things- — things he would never 
otherwise dream of doing, simply because he 
has lost his sense of responsibility. 

For instance, I have had patients who took 
as much as sixty grains of morphia in a single 
dose, an overdose for about one hundred and 
fifty people, and about fifty grains more than 
the takers- could possibly assimilate, or than 
they required- in order to produce the desired 
effect — an excellent illustration of how the 
addiction destroys all judgment and all sense 
of proportion. 

There is one phase of drug addiction which 
has worked seriously to the detriment of the 
American public, and which has made the situ- 
ation infinitely more acute than it otherwise 
might have been. This is the indiscriminate 
sale of narcotics and other habit-forming 
drugs. On the continent such a condition 
simply could not exist. There are no doped 
patent medicines, no drugs, no " soothers' ' or 
" s'edatives ' ■ to which the man restricted in 
his alcoholic potion can turn. When Europe 
"goes dry" — unless it becomes highly Ameri- 
canized and poison-polluted in the meantime, 
which is hardly likely — Europe will stay dry 
— and very s^ober. Except for coffee bibbling 



92 HABITS THAT HANDICAP 

and tea tippling, there is nothing else for it 
to do. 

This suggests also a comparison with our 
Oriental second cousins, a comparison in which 
we come out decidedly second best. We have 
laid much fatuous and flattering unction to 
our souls in the past in respect to the fact 
that while we might, for instance, number 
among our population many hundreds of thou- 
sands of drunkards and drug fiends, at least 
we had never sunk to the Chinese level of 
becoming opium-smokers. 

Now I want to emphasize right here that 
the only reason why opium-smoking has been, 
up to the present, less prevalent in the United 
States than in China is merely because the 
preparation of opium and the machinery for 
smoking it are not convenient. 

If opium-smoking had been generally coun- 
tenanced in America, if the sale of the pure 
drug had been for generations fostered here 
as it has been in China, if houses for its sale 
and preparation had been found everywhere, 
if its social aspects had been considered agree- 
able, if society had put the stamp of approval 
on it, opium-smoking would be as prevalent 
here as it has been in China. 

Our human nature is essentially little dif- 



THE MIND OF THE ADDICT 93 

ferent from that of the Chinese — but lack of 
opportunity is everywhere recognized as a 
great preservative of virtue. Were the con- 
ditions the same in both cases, there is no 
reason to suppose that opium would not be 
smoked here as much as in China. 

On the other hand, the alkaloids of opium, 
administered hypodermically or as ingredients 
in many patent medicines, are thus conveni- 
ent, and, as a result, this phase of the evil 
has reached overwhelming proportions. Nor 
have we any cause for congratulation upon 
our particular form of the vice, for opium- 
smoking is infinitely less vicious than mor- 
phine taking. 

I find that my conviction in this matter is 
shared by no less an authority than Sir Wil- 
liam J. Cullins, K.C.V.O., D.L., M.D., B.Sc, 
F.R.C.S., and President of the Society for the 
Study of Inebriety. 

Sir William, writing in the British Journal 
of Inebriety, says: 

"Before I went to the International 
Opium Conference at the Hague, I made 
it my duty to visit ' Chinatown J in East 
London — Pennyfields and Limehouse 
Causeway — and saw the opium-smoking 



94 HABITS THAT HANDICAP 

dens' for myself. I confess I came away 
with the reflection that that vice, objec- 
tionable as indeed it is, is less anti-social 
and less tissue-destroying than some of 
the results of the gin-palace. It is idle to 
wax eloquent over 'Lo, the poor Indian, 
whose untutored mind sees God in stone 
and hears Him in the wind' with his 
opium-pipe, and to palliate or ignore the 
morphine maniacs, the cocaine addicts, and 
the alcohol fiends who infest society.' ' 

And this suggests also that our national 
vice of cigaret-smoking may be even more 
harmful, and even more deteriorating to 
morals, than is the Oriental vice of opium- 
smoking. 

For the narcotic action of tobacco produces 
a peculiar cunning and resource in conceal- 
ment; it develops, when occasion arises, the 
desire to deceive and the desire to shift obli- 
gation and evade direct responsibility. To- 
bacco does this more mildly than opium, and 
it does so more appreciably with, boys than 
with men; but, as with opium, it is part of the 
narcotic effect in all cases. 

Eemember that if a man smokes and in- 
hales tobacco excessively — which is a usual 



THE MIND OF THE ADDICT 95 

custom among cigaret-smokers — lie is narcotiz- 
ing himself more than when he smokes opium 
moderately. 

This observation may serve to give us a 
more comprehensive and* a better qualified 
viewpoint of the mental aspects of toxic addic- 
tion. 

There are certain characteristic changes 
that are almost invariable in the mind of a 
chronic drug-taker. For one thing, it is no- 
torious that, no matter who he is nor how he 
acquired the addiction, on the smallest excuse 
he will advise others to take the drug when- 
ever pain or fatigue give the slightest occa- 
sion for it. While he may grow callous to 
everything else, he will have an abnormal sym- 
pathy with suffering. Thus it will readily be 
seen that there are few more dangerous mem- 
bers of society than the physician who is 
addicted to a drug. 

This same thing is true of nurses who have 
developed the habit. For a sympathetic 
woman is* even more likely to yield to the 
pleadings of suffering patients than is the 
sympathetic doctor. Like the doctor, the 
nurse is human, neither iron-nerved nor iron- 
muscled. Frequently she is under terrific 
strain, which might impel toward the use of 



96 HABITS THAT HANDICAP 

stimulants of any kind. That which she can 
administer to herself by means of the hypo- 
dermic is closest to hand, is easiest to take, 
and least likely to be discovered. 

Also, the nurse is as susceptible to pain as 
are any of us. Suffering, with the means of 
alleviation at her hand, and, as with the doctor, 
what is more natural than that she herself 
should use the hypodermic for her own relief? 

Thus it comes about that probably a larger 
proportion of trained nurses than of doctors 
are habitual drug-users. This is not a state- 
ment which is critical of the profession, for 
if all mankind knew of drugs, possest hypo- 
dermics and knew how to use them, a very 
large proportion of the human race would 
resort to this quick and effective, if inevitably 
perilous, means of finding comfort when agony 
assailed them. 

Our usual methods of dealing with these 
cases* of toxic addiction are hopelessly inade- 
quate to influence favorably the mind of an 
habitue. One of the most grievous errors we 
commit in this connection is to hold the threat 
of punishment over his head. 

Punishment breeds rebellion, and a rebel- 
lious man is a most unlikely subject for re- 
form. For the inflamed brain not only carries 



THE MIND OF THE ADDICT 97 

grudges, but is almost sure to intensify them. 

For instance, the man discharged from em- 
ployment, or arrested while in an abnormal 
alcoholic state, is stimulated to resent — not 
to repent. The employer who discharges a 
good man from his position because of drunk- 
enness not only fails to deal intelligently with 
the subject or the man, but may very likely 
be committing a crime against society by rob- 
bing it of a useful citizen, while at the same 
time forcing a useless one upon it. 

The victim of drugs differs psychologically 
very materially from the victim of drink. 
Until his trouble has reached an acute stage, 
the alcoholic feels little interest in any remedy 
for his alcoholism. Many even deny to their 
friends and themselves that they are alco- 
holics, until they have reached the point akin 
to hopelessness in their friends' eyes and 
their own. 

The drug-user, on the other hand, knows 
he is* a victim as soon as he becomes one ; in 
ninety-nine cases- out of a hundred he is in- 
tensely desirous of being relieved of his habit. 
Thousands of alcoholics will defend their vice. 
[A. library might be filled with books glorify- 
ing alcohol and the good fellowship and con- 
viviality that it is supposed to promote. Yet 



98 HABITS THAT HANDICAP 

one might search a long time for a victim of 
any drug habit who would speak affectionately 
of the substance which has enthralled him. 
Nor has any poet ever written glorifying the 
marvels of morphine. 

There is another phase of the drug evil 
which is most important. This is the necessity 
for educating the public in regard to the very 
definite relation between alcoholism and in- 
sanity. There lies a public peril of unap- 
preciated magnitude in the fact that mere 
deprivation, the only method so far followed, 
has been — and if it is not corrected will con- 
tinue to be — one of the principal feeders of 
our insane asylums. 

The case is somewhat different with drug 
victims. Ordinarily they will not become in- 
sane, unless deprived of their drug, altho in 
the final stages of the habit they are likely 
to become incompetent, and subject to certain 
hallucinations, imagining the existence of plots 
against them, suspecting unfairness on every 
hand, taking easy offense — exhibiting, in fact, 
a generally distorted mental condition. 

This brings us to the kernel of the matter. 
No man who has become addicted to the use 
of alcohol or drugs can possibly abandon them 
unless he has first undergone a complete 



THE MIND OF THE ADDICT 99 

mental change, and in ninety-nine cases out 
of a hundred this alteration of the mental 
state will not come until he has experienced 
a physical revolution. 

The reason for this is simple. With alcohol, 
excessive use really deteriorates body and 
brain tissue, and tissue degeneration trans- 
forms for the worse the entire physical and 
mental makeup of a man. The confirmed al- 
coholic is in a state which, save in rare in- 
stances, nothing short of specialized medical 
treatment can correct. 

Mere general building-up of bodily tone is 
as ineffective with alcoholics as is enforced 
deprivation or punishment. I emphasize this 
point particularly because many men are 
afraid to take treatment for alcoholism, lest 
through it they lose their standing with them- 
selves or with their neighbors. Self-respect 
must be protected at every stage of the strug- 
gle as the patient's only hope. But this hope, 
either with drug or alcohol victim, is delusive 
unless first preceded by the definite physiologi- 
cal change which depoisoning treatment brings 
about. 

Then, with a system free from the drug 
toxins and tissue-poison accumulations, and 
with a nervous and physical organism stabil- 



100 HABITS THAT HANDICAP 

ized by active hygienic measures, the vast 
majority of poison addicts, no matter what 
the nature of their poison, can be restored to 
an absolutely normal condition. And if they 
are really desirous of keeping clean, they 
will stay this way. 

For there is no reason, except their own 
unwillingness to quit, why their habit should 
not be as definitely removed as would be the 
results of auto-intoxication, mumps, or focal 
infection — once these conditions were cor- 
rected. And herein the patient must minister 
to himself. 



vn 

The Problem of Prohibition 

Sanitariums, hospitals, and insane asylums 
are crowded with victims of alcoholic toler- 
ance, alcoholic abnormality, and alcoholic de- 
generation. In private practise the number of 
cases directly resulting from, or complicated 
by, alcohol runs into the scores of thousands. 

And while alcoholism is by no means so 
fatal a condition as tuberculosis, yet, inas- 
much as there are probably forty alcoholics 
to every consumptive in the United States, the 
death-rate from alcohol must be a perpetual 
source of joy to the undertaker. 

This, by way of preamble to establish, is 
what should be self-evident: that alcohol cre- 
ates a physical, mental and moral deprecia- 
tion, and that the alcohol addict is a sick man. 

Now one of the grim things about the alco- 
holic sickness is that it generates an over- 
powering craving for the thing that causes the 
sickness. This terrible craving — this racking 
of soul on the Procrustian bed of booze — can 

101 



102 HABITS THAT HANDICAP 

be palliated by only one thing — a little more 
of "the same." 

It is no use trying to placate the craving 
with substitutes that are "just as good." 
There isn't anything "just as good" as alco- 
hol for an alcoholic, except something that 
may be much worse, the effects of which may 
be even more degrading and soul-searing than 
are the effects of alcohol. 

Yet now the manufacture and sale of al- 
cohol for beverage purposes in the United 
States is forbidden. How this may affect the 
life, even the reason itself — infinitely more 
important than life — of scores of thousands 
is a matter which those responsible for the 
law seem to have rather consistently ignored. 
And yet this is perhaps the most vital ques- 
tion in connection with prohibition. 

Upon its solution, and upon the provisions 
that must be made to meet this solution, de- 
pends the success or the failure of the move- 
ment. If the remedy proves, on experience, 
to be infinitely worse than the disease it was 
intended to relieve, it is only reasonable to 
believe that we may be glad to have our dis- 
ease back again 1 — as the lesser of the two 
evils. 

For we are suddenly depriving thousands 



THE PBOBLEM OF PROHIBITION 103 

of habitues of necessary stimulants, something 
which should never be done with any chronic 
case of alcoholism without having first made 
provision to unpoison him of the condition 
which makes those stimulants necessary. 

The result will be a stampede for substi- 
tutes. Shoe-blacking, patent medicines in an 
alcoholic menstrum — anything and everything 
that smells or tastes like alcohol — will be 
poured into the systems of addicts. 

Some "herpicides," carrying as much as 
40 per cent, of alcohol, are even now achiev- 
ing a tremendous vogue in certain sections of 
the country, while flavoring extracts, such as 
Jamaica ginger — containing 93.5 per cent, of 
alcohol — are among the most dependable of 
"nips" for those who don't care so much for 
the form in which they get their alcohol as 
they do for the alcohol itself. 

"Tonics," "bitters," "compounds," "stom- 
ach cures," and other alcoholic combinations, 
are being shipped by the carload into arid 
States. 

Kerosene and gasoline cocktails will achieve 
an ever-increasing sphere of favor. Varnish, 
turpentine, and the deadly wood-alcohol will 
furnish their quota of victims. Blind-tigers, 
bootleggers, and illicit stills will wax obese. 



104 HABITS THAT HANDICAP 

Drug stores will reap a golden harvest from 
putting up "prescriptions" for intoxicants. 

The cognoscenti are instructing those 
not quite so well informed as to the striking 
possibilities of a few raisins added to a bottle 
of cider. They are telling what will happen 
when an eighth of a cake of yeast is incorpo- 
rated in a bottle of "near beer" or grape- 
juice. They are demonstrating the chemical 
reaction that takes place when water, sugar, 
and a little yeast are encouraged to make 
nature do its worst. 

Then, too, the manufacturers of small 
"home" stills are doing a thriving business 
in preparation for the dry wave. The most 
popular of their products is the kind that 
can be used in kitchens. One full-grown still 
is guaranteed to turn out sufficient "fire- 
water" to keep every member of a large 
family in a perpetual state of intoxication. 

So, in one hundred thousand different ways, 
according to no less qualified an authority 
than the United States Treasury Department, 
men and women may avail themselves of the 
poisonous comfort of alcohol. 

But, most dangerous and most far-reaching 
of all, the use of health-destroying and habit- 
forming narcotics will increase beyond any- 



THE PEOBLEM OF PKOHIBITION 105 

thing ever dreamed of in the palmy days of 
alcohol. 

One brand of " cough medicine" recently 
examined by the Government experts, was 
found on analysis to contain 45 per cent, of 
grain alcohol, with 1.9 per cent, of opium 
thrown in for good measure. 

Under the Harrison Act, this and other 
combinations of alcohol and opium can be sold 
without restriction in any section of the coun- 
try quite irrespective of local conditions. 

This is entirely apart from the pernicious 
activities of the druggists in providing for the 
inevitable narcotic increase following prohibi- 
tion. In this connection it is interesting to 
note that the wholesale druggists, during the 
month of January, bought more narcotic drugs 
than in the entire year of 1918, and the de- 
mand was so great in February that the 
manufacturers limited the amount of drugs 
sold to a wholesaler. So it is evident that 
these altruists intend to be bloody, bold and 
resolute in helping their drug-addict victims 
on their swift way to hell. 

For under the present Federal laws the 
druggist is permitted to put up and to dis- 
pense any preparation he may see fit to sell, 
so long as those come within the very lax and 



106 HABITS THAT HANDICAP 

lenient minimum dosage scale — which, is a 
very liberal dosage, indeed — permitted by the 
Federal Narcotic Law. 

He is permitted to use certain minimum 
quantities of habit-forming drugs without mak- 
ing any accounting to the Government for 
these. He is at liberty to sell, without legal 
restriction, combinations containing habit- 
forming narcotics, which, if used for a long 
enough period of time, are quite as certain 
to establish a drug tolerance and a drug 
craving as tho they had been taken "straight." 

For it is not the quantity of the drug taken 
that creates the craving for more of the same. 
It is the nervous and organic reaction to the 
drug itself, plus the regularity of its admin- 
istration, that starts the conflagration. 

And remember, that combining the opiate 
with pink syrup, or with other ostensible 
"remedies," does not destroy the physical 
action of the narcotics. All the powerful po- 
tentialities for evil — for physical, mental and 
moral shipwreck — are present in these nos- 
trums. 

Some idea of the dangers from these may 
be gained from the experience of the late Dr. 
Asbel P. Grinnell, for seventeen years Dean 
of the Vermont Medical College. After the 



THE PEOBLEM OP PBOHIBITION 107 

adoption of prohibitory legislation in Ver- 
mont, Dr. Grinnell sent out to all wholesale 
and retail drug stores,, general stores, and 
groceries that carried drugs as a part of their 
equipment, a letter of inquiry concerning the 
sale of habit-forming drugs. 

Such was the personal standing of Dr. Grin- 
nell in Vermont that he received replies from 
all but two or three of those addrest. These 
replies indicated that sales of habit-forming 
drugs had increased so rapidly following the 
arid wave that, at the time of inquiry, there 
was a daily consumption of opium and its 
alkaloids — morphine, heroin and codeine — 
equal to one and one-half grains for every 
man, woman and child in Vermont! 

This alarming increase was attributed solely 
to the prohibition of the use of liquor. Dr. 
Grinnell concluded that the attempt to en- 
force abstinence upon the man who wants to 
drink is not only ineffective, but actually de- 
structive. And that, while society may save 
itself from a few drunkards by prohibition, it 
is more than likely to get a disproportionate 
number of lunatics and drug-fiends to fill their 
places. This opinion is confirmed by Dr. 
Royal S. Copeland, Health Commissioner of 
the City of New York, who recently pointed 



108 HABITS THAT HANDICAP 

out that the increased consumption of drugs 
would be inevitable under a prohibitory re- 
striction against the sale of alcohol. And this 
consumption will by no means be confined to 
the criminal class. 

"Already you will find drug-users, " said 
Dr. Copeland, " among lawyers, judges, doc- 
tors — in fact, in every strata of society. In 
the underworld of New York you will find 
10,000 drug addicts, and every crime of vio- 
lence committed you may know has been per- 
petrated by one of them. It is safe to say 
that in all New York one person in thirty is 
a victim. 

"During one month, one drug store sold 
500 ounces of cocaine, enough to send 2,500 
people to hell. And worse than all is the fact 
that there are physicians, members of my own 
profession, writing from 100 to 200 prescrip- 
tions a day for 25 cents a prescription. They 
should be boiled in oil, and if there is a hell 
they should go there and sizzle for eternity." 

These are strong words, but they seem to 
be warranted by the facts of the case. 

In the South, where State prohibition has 
been enforced for a number of years — against 
the negro and the "poor white/ ' anyhow — 



THE PEOBLEM OF PKOHIBITION 109 

matters are in even a worse shape, as every 
traveler knows. 

Unable to obtain alcoholic surcease from 
real or imagined ills, these victims of the 
" take-something' > habit have gravitated to 
cocaine and heroin, which they seem to be able 
to obtain in almost unlimited quantities. 

So that now, in North Carolina, for every 
eighty-four patients admitted to the State 
insane asylums one is a drug-addict. In 
Georgia, one in forty-two is afflicted with 
drug disorder, while in one Mississippi hos- 
pital, out of every twenty-three patients one 
is a slave to cocaine. 

It works' "t'other way around with equal 
facility.' ' In India and China, following the 
forced reduction in the consumption of opium, 
there has been a correspondingly marked in- 
crease in the use of alcohol. 

Now this is a condition, not a fanciful 
theory. It is a condition not confined to any 
race or to any form of civilization. Nor does 
the character and quality of the "dope" mat- 
ter so much as does its availability. 

About it might be said that narcotic addic- 
tion is a pervading human impulse. So, if 
we do not want to cause death, insanity, and 
millions of hours of needless suffering, we 



110 HABITS THAT HANDICAP 

must be prepared to reckon with this impelling 
impulse. 

This does not mean that prohibition in itself 
is an evil. Indeed, the prohibition of the 
manufacture and sale of alcohol for beverage 
purposes is perhaps one of the greatest bene- 
fits ever forced upon an unappreciative popu- 
lace. Many distillers and liquor dealers them- 
selves admit this. 

But prohibition of alcoholic beverages alone 
is not enough. There must also be prohibition 
of the sale of poisons — poisons far more de- 
structive in their influence than alcohol. 
Therefore, we must take a much broader view 
of the problem than we have thus far per- 
mitted ourselves to take. 

For one thing, we must learn to regard the 
alcoholic as a sick man — not as a criminal 
or a degenerate. Indeed, most addicts are 
no more to be blamed for their condition than 
is a hunch-back or a cretin to be blamed for 
his condition. 

Yet, let me again emphasize, narcotic addic- 
tion is not inherited. This is an acquired 
trait. No one is ever born with a taste for 
morphine, or hasheesh, or cocaine, or alcohol. 
This is an erroneous idea, harped on through 
all the ages, as an excuse for over-indulgence 



THE PEOBLEM OF PROHIBITION 111 

and as an argument advanced by the excuser 
for not breaking the shackles of his habit. 

Yet the fact remains that millions are born 
with a weak, unstable mentality and a flabby 
will, prone to excess in everything except 
well-doing and deficient in resistance to every 
form of temptation. Their highly strung nerv- 
ous systems crave the abnormality which alco- 
hols and drugs offer. They are sick. And 
we are doing nothing to save them. 

This is the crime of our social order against 
the drunkard. It is a crime intensified by our 
unwillingness to cooperate with the addict 
toward his own reclamation, and further in- 
tensified by our supine willingness to allow 
him to be poisoned by drugs infinitely worse 
in their effect than alcohol. 

For what avails it to deprive a drinker of 
pale ale and leave him free to buy and con- 
sume any amount of paregoric? Where is the 
gain in prohibiting the sale of high-balls and 
encouraging the demand for heroin? And 
what use is it to restrict the consumption of 
beer and light wines, which are relatively 
harmless, and stimulate the doping with co- 
deine and the snuffing of cocaine- — habits in- 
finitely more injurious? 

We should at once institute some intelligent 



112 HABITS THAT HANDICAP 

effort to cope with drink and drug-addicts. 
Under our present system the alcoholic is 
taken to some city hospital, or to any of the 
big State hospitals throughout the country, 
and treated as an "emergency case." 

Usually the first thing done to him is to 
deprive him of booze. Then he has to take 
the deprivation consequences. If he is an 
old chronic, whose cells are saturated with 
long indulgence in alcohol, he stands an excel- 
lent chance of developing delirium tremens. 

If he escapes dying, he may be more than 
likely to develop an alcoholic "wet brain." 
This may mean alcoholic insanity. If he has 
money he may now become a patient at some 
private sanitarium for an indefinite period. 
If he is without money, he may board at 
some State hospital or asylum for the remain- 
der of his life. For without definite medical 
care, a permanent relief of "wet brain' ' is 
almost in the miracle class. 

Under our present antiquated methods there 
is no intelligent classification of cases. The 
treatment is hopelessly routine and uniformly 
"expectant." Little is done to rid the system 
of the accumulated toxins of alcohol excesses. 

Outside of a few sweat-baths, — which aren't 
a drop in the bucket of treatment necessary 



THE PEOBLEM OF PEOHIBITION 113 

to rehabilitate an addict, — no effort is made 
to scour his cells and glands clean of the ele- 
ment that makes them cry out for further nar- 
cotization. And but little attempt is made to 
build up the nervous system and to increase 
the moral, physical and nervous resistance to 
alcoholic desire. 

Hence it is that relatively few cases can be 
normalized and ultimately salvaged. And the 
saddest feature of the whole matter is that 
we — the great public — are absolutely indiffer- 
ent whether they are or not. 

Here are a few items of testimony to prove 
this. At the present time there are few pub- 
lic institutions where a man, desiring to be 
freed of the craving for alcohol or drugs, 
might go either as a charity patient or a 
"pay" patient. And no recognized charity 
makes any provision for medical treatment of 
the drunkard. 

The one place in New York set aside for 
special work in the reclamation of alcoholics 
has been finally closed as a failure. The 
neglect to use successful means of treatment 
and the pitiful lack of knowledge as to how to 
deal with this type of patient, both in a medi- 
cal and in a sociological way, foredoomed the 
venture. And more's the pity! 



114 HABITS THAT HANDICAP 

However, we are still sending missionaries 
and money to China — in many respects the 
most enlightened country on earth. This may 
help some of us to maintain our psychical 
equanimity. 

Only two States in the Union — Massachu- 
setts and Iowa — maintain colonies for alco- 
holics, colonies where nerves and bodies may 
be built up by contact with Mother Earth, 
while poisoned systems are unpoisoned 
through natural elimination, and through the 
vivifying and toxin-consuming effects of 
oxygen. 

This is a beginning. But it isn't enough. 
Nor is its scope sufficiently wide. For, in 
addition to segregation and healthful coloniza- 
tion, some definite medical treatment should 
be undertaken which would effectually cleanse 
body, nerves and brain. 

There is only one scientific way to accom- 
plish this. This is to establish, in every metro- 
politan center, an institution devoted to the 
relief of drug and alcohol addiction. This 
hospital should be fitted out with the most 
modern and best approved methods of de- 
poisoning drunkards and narcotic addicts, and 
putting them in a physical and mental condi- 
tion for keeping themselves depoisoned. 



THE PKOBLEM OF PEOHIBITION 115 

Complete descriptions of this treatment 
have been published from time to time in the 
most prominent medical journals in the coun- 
try. In fact, Dr. Lambert himself, the Presi- 
dent of the American Medical Association 
was the first to give an account of it. 

If any physician among my readers would 
like to know more about this treatment, I 
should be glad to send him complete and ex- 
haustive details concerning it. 

Following the medical treatment, there 
should be a course of exercises, baths, elec- 
tricity, and every variety of physical thera- 
peutic measure calculated to put body and 
nerves in the best possible condition of health. 

Institutions qualified to do this class of 
work should be established, without delay, in 
order to provide the alcoholic with a certain 
means of recovery. 

If such institutions were available every- 
where throughout the country — organized pos- 
sibly as Government Units — more could be 
done to clean up the affliction of drunkenness 
and prevent the impending increase in drug 
consumption than could be accomplished by 
all other agencies combined. 

If these retreats are not available by the 
time the country goes "bone dry," the prohi- 



116 HABITS THAT HANDICAP 

bitionists will have to assume the responsibil- 
ity for a very terrible state of affairs. Unless 
something is done, and done soon, there won't 
be mad-houses enough in the land in which to 
sequester those crazed by drugs, "dope" and 
drink. 

Once upon a time the question was asked, 
"Am I my brother's keeper?" There is only 
one answer to this question. It shouldn't be 
hard to find it if our hearts are in the right 
place. 



VIII 

Why the Addict Needs Definite Tkeatment 

In one of the largest hospitals in the United 
States I once ran across an old woman croon- 
ing while she rocked an imaginary baby. She 
had been formally and legally adjudged in- 
sane by the State's experts. As a matter of 
fact, she was suffering only from an halluci- 
nation due to alcoholic deprivation. 

I suggested definite medical treatment when 
I discovered that she was about to be trans- 
ferred from the alcoholic ward to the insane 
pavilion. In two days after the administra- 
tion of this treatment she had lost all her 
hallucinations. 

I mention this case as typical of thousands 
that are every year allowed to become perma- 
nent mental derelicts because of the lack of 
intelligent consideration of their condition. 

I am firmly convinced that commitments for 
insanity in the United States might be de- 
creased by one-third, if in every case where 
insanity was suspected, but in which an alcoholic 

117 



118 HABITS THAT HANDICAP 

or drug history could be traced, the patient 
could be subjected to the necessary medical 
treatment before the final commitment was 
made. 

For the sudden deprivation of drugs and 
alcohol which follows the imprisonment of 
alcoholics and drug-users upon disorderly or 
criminal charges has produced thousands of 
cases of insanity sufficiently marked to war- 
rant the subjects being placed in insane 
asylums. 

Certainly, no man or woman with any 
inkling of the real facts of the matter will 
go to any institution for relief from drug ad- 
diction where the only treatment offered is that 
of enforced deprivation, for he or she knows 
that such deprivation may mean death. 

The method of reduction, as universally 
practised, is rarely carried to the point where 
it would do any good, even if good were thus 
possible. But it is not generally possible. 

In the first place, lessening the dose is of 
little avail; there is as much suffering in the 
final deprivation of a customary quarter of 
a grain as of twenty grains. 

Only recently we had just such a case at 
our hospital. This man, a physician, had, 
with the aid of his wife and a nurse, taken 



DEFINITE TEEATMENT NEEDED 119 

the "diminishing dose" treatment, and had, 
by a miracle, entirely "gotten off" his mor- 
phine. When he came to ns he had been 
without even a fraction of a grain for more 
than two weeks. 

Yet he had just as intolerable a craving for 
the drug, his withdrawal symptoms were quite 
as acute, and his restlessness every bit as 
pronounced as when he first commenced his 
"cure." His fierce yearning for the poison 
had not been diminished one iota. 

After four days of active depoisoning treat- 
ment, however, the doctor was absolutely re- 
lieved of even the slightest desire for mor- 
phine. And after a lapse of many months, 
he still continues in this state — and no doubt 
always will. 

For any man who would undertake, of his 
own initiative, the definite treatment of his 
own case, with all the suffering the depriva- 
tion treatment entails, can be thoroughly relied 
upon to refrain from ever again returning 
to a condition where a repetition of this 
experience would be necessary. 

Another thing, it can not be ascertained by 
gradual reduction whether there is any dis- 
ability which makes morphine necessary, since 
no intelligent diagnosis can be made so long 



120 HABITS THAT HANDICAP 

as a patient is under the influence of even 
the smallest quantity of the drug. 

A patient whose consciousness of pain is 
dulled or eliminated by the use of drugs can 
not accurately describe to a physician the most 
important symptoms of his ailment. "Without 
the assistance of such a description the phy- 
sician is so handicapped that all the skill 
which he has acquired in practise, and all the 
knowledge he has gained from study, are 
likely to be of no avail. 

So, obviously, the first step in taking up a 
case should be to discover whether any such 
disability is present, and if so, whether it is 
one that can be corrected. Otherwise it may 
be a waste of time to try to correct it. 

One of the most difficult problems of my 
work has been to discover ways by which the 
medical profession can be made to under- 
stand the really serious meaning of chronic 
alcoholism. This is very important, for most 
delirium, the primary cause of which lies in 
alcoholism, is amenable to treatment. 

It is either exhaustion or lack of alcohol 
which first produces delirium in an alcoholic 
case, whether that exhaustion is due to the 
patient's inability to assimilate food or alco- 



DEFINITE TREATMENT NEEDED 121 

hoi, or whether it is due to the fact that, being 
under restraint, alcohol is denied him. 

Many friends of alcoholic subjects and many 
physicians in private practise have believed 
that they were doing the alcoholic a great 
service when they put him where he could 
not get alcohol, and helped him over the first 
acute stages of the period of deprivation by 
the administration of bromide and other 
sedatives. 

Yet this often predisposes to delirium, and 
then to a "wet brain.' ' If the patient sur- 
vives this, his next development is more than 
likely to be prolonged psychosis, or, in the 
end, permanent insanity. 

It is because of this that I consider the 
chronic alcoholic moiss clearly entitled to 
prompt and intelligent medical treatment than 
most other sick persons. "With the alcoholic, 
as with the drug-taker, the first thing to be 
accomplished is the unpoisoning of the body. 

In order to secure this result, it is first 
necessary to keep up the alcoholic medication 
with sufficient sedatives, employing great care 
lest the patient drift into that extreme nervous 
condition which leads to delirium. If delirium 
does occur, nothing but sleep can bring about 
an improvement. This is the point of devel- 



122 HABITS THAT HANDICAP 

opment at which physicians, not properly in- 
formed in regard to such cases, are likely to 
employ large quantities of hypnotics. And 
frequently this course is followed until the 
patient is finally "knocked out." 

In many instances an accumulation of hyp- 
notics in the systems of persons thus treated 
has proved fatal. 

There are no circumstances in which it is 
advisable for a physician in private practise 
to attempt to handle a case of chronic alcohol- 
ism in the patient's own environment. Ef- 
forts to do this are constantly made, with a 
result that many needlessly die from lack of 
alcohol, while an even more tragic repult is 
the unnecessary entrance, first, into the psy- 
chopathic wards of our hospitals, and thence 
into our asylums for the insane, of innumer- 
able cases which could have been prevented by 
intelligent treatment for alcoholism or drug 
addiction. 

At present the only public recognition of the 
alcoholic is manifested through some form of 
penalization. He loses his employment, he is 
excluded from respectable society. In extreme 
cases he is taken into court and subjected to 
reprimand, fine, or imprisonment. 



DEFINITE TREATMENT NEEDED 123 

Nothing is done to bring about his reform, 
except as the moral weight of the non-remedial 
punishment may arouse him to his peril and 
set his own will at work. Instances where 
this occurs are rare, because the crisis always 
comes when, through the influence which al- 
cohol has wrought upon him, his brain has 
been befogged and his will weakened. Society 
does virtually nothing to awaken that will or 
to assist its operation. 

The man whose drinking has so disarranged 
him physically or mentally that he is obviously 
ill is, it is true, taken to the alcoholic ward 
of some hospital, but no effort is there made 
to treat his alcoholic addiction. For example, 
Bellevue and Kings County hospitals, New 
York's two "alcoholic wards, " are institutions 
devoted especially to the treatment of emer- 
gency cases. 

As a matter of fact, the alcoholics usually 
taken to these hospitals are merely "sobered 
up." As soon as they are sobered and have 
achieved sufficient steadiness of nerve to make 
a discharge possible, they are turned out again 
into the liquor-ridden city, with their crav- 
ing for the alcohol which mastered them no 
weaker, and with their resolution to resist its 
urging no whit stronger than it was before 



124 HABITS THAT HANDICAP 

the crisis in their alcoholic history engulfed 
them. 

Not infrequently it follows that, while still 
in full possession of the alcoholic addiction, 
the addict will, in addition, contract the hypo- 
dermic habit, a complication of addictions that 
only rarely is dealt with successfully. 

It is also a fact, and one not generally rec- 
ognized, that the commitment of the alcoholic 
to an ordinary penal institution is a perilous 
experiment. The experiences which various 
authorities connected with the Department of 
Correction in the City of New York have had 
with drug and alcohol smugglers indicate a 
condition that exists more or less generally 
in penal institutions throughout the country. 

The drug-user or alcoholic who has been 
locked up in prison is in no way relieved of 
his craving for the substance which is harm- 
ing him, and his efforts to obtain it will be 
desperate. 

The men who surround him as prison- 
guards are not usually of a high type. If the 
man has money, many of these guards, espe- 
cially if they themselves be drug or liquor 
addicts, will arrange to smuggle to him what 
he craves. 

Inasmuch as it is materially easier to smug- 



DEFINITE TBEATMENT NEEDED 125 

gle drugs into a prison than it is alcohol, 
many alcoholics have been changed in prison 
to drug-takers, and after this change the meta- 
morphosis of the mere drunkard into an actual 
criminal has often occurred. 

The administration of a definite medical 
treatment should, therefore, be regarded as 
imperative in all cases of drug addiction, and 
in most cases of alcoholic addiction that ap- 
pear in our prisons. In the cases of alco- 
holic addiction, imprisonment should end in 
first-offenders with the completion of the treat- 
ment and the restoration of the subject's mind 
to normal. 

I can not too strongly or too frequently 
reiterate the statement that there is no more 
desperate illness than chronic alcoholism. 
Nor is there any illness that requires more 
intelligently directed and definite treatment 
or more sympathetic and human understand- 
ing. 



IX 

Breaking Barleycorn's Bonds 

During the summer of 1913 I visited a large 
hospital in Edinburgh and discust alcoholism 
and its treatment with the visiting physician. 

"Is there no place in Scotland for the care 
of acute alcoholism V 9 I asked. 

"No. If an intoxicated person is locked up 
by the police and develops delirium he is sent 
here, and we do what we can for him by the 
old methods.' ' 

"You offer no definite medical help along 
special lines V 9 

"No; we have none to offer/ 9 he answered, 
hopelessly. 

He showed me two cases in the general 
ward. One man in a straight jacket was suffer- 
ing from delirium tremens, his face terribly 
suffused. He was in a pitiable state, and 
nothing was done for him. 

"May I see his chart V 9 I requested. 

After I had examined it, it became immedi- 

126 



BKEAKING BABLEYCOBN'S BONDS 127 

ately apparent that the patient's condition 
was due to lack of his usual drug. It was his 
third day in the ward. 

"Nothing but sleep will save him/' I said, 
and suggested medication. This was admin- 
istered. 

In three or four minutes the patient was 
relaxed and taken out of the straight] acket. 
I made certain suggestions regarding general 
stimulation for the bowels and the kidneys 
and also suggested some modification in the 
diet. The next day I found the patient im- 
proved after twelve or fifteen hours of sleep, 
and wholly free from delirium. His case had 
now become simply a matter of recuperation. 

Another case had lived through several days 
of delirium tremens which had been followed 
by a "wet brain"; the visiting physician con- 
sidered this patient a fit subject for the psy- 
chopathic ward. 

I asked the patient questions about himself. 
He was sure that he had been out the night 
before, and pointed out one of the internes 
as his companion during the hours of dissi- 
pation. His case was regarded at the hos- 
pital as almost certain to end in an asylum. 
I suggested treatment, and within two days 
the man's mind was entirely cleared up. 



128 HABITS THAT HANDICAP 

These instances of successful and prompt 
relief occasioned considerable surprize among 
the hospital physicians, who frankly admitted 
that they knew no method except to keep the 
patients under restraint, and, if necessary, 
feed them according to existing rules, keep 
their bowels open and their bladders free, 
and hope for the best. 

And this was an institution which is sup- 
posed to represent the best medical learning 
in the United Kingdom. I found similar con- 
ditions in the great hospitals of London, Paris, 
and Berlin; so the Scotch institution is no 
exception to the general European rule. 
Everywhere I was frankly informed that the 
medical staff knew of nothing to be done in 
alcoholic cases beyond deprivation and penal- 
ization. 

Nor have we been more scientifically pro- 
gressive in the United States. We are follow- 
ing virtually the same unenlightened methods. 
How important our shortcoming is may be 
obvious when it is remembered that alcoholic 
patients comprise one-third of all the cases 
admitted to Bellevue Hospital in New York. 

The alcoholic differs notably from the per- 
son addicted to drugs. A drug-taker, deprived 
of his poison, will experience in the early 



BREAKING BARLEYCORN'S BONDS 129 

stages only acute discomfort and a natural 
longing for the drug of which he has been 
deprived. His unfavorable symptoms can al- 
ways be relieved by the administration of the 
drug. 

The chronic alcoholic, however, deprived of 
his stimulant often drifts into a delirium which 
can not be relieved even by the administration 
of his accustomed tipple. No more terrible 
spectacle can be imagined than that of an 
acute case of delirium tremens; no patient 
needs more careful watching, in order that 
unfavorable developments may be avoided. 
And once delirium sets in, no type of case is 
medically so difficult to handle. 

The man who for long periods has been 
saturated with alcohol, and who is suddenly 
deprived of it is, I think, more to be pitied 
than almost any one I know. Yet relatives, 
friends and physicians frequently enforce 
complete abstinence, thinking that by so doing 
they are rendering the patient a kindly 
service. 

The relation of tobacco, especially in the 
form of cigarets, and alcohol, or even opium, 
is a very close one. For years I have been 
dealing with alcoholism and morphinism, have 
gone into their every phase and aspect, have 



130 HABITS THAT HANDICAP 

kept careful and minute records of almost ten 
thousand cases. Yet I have never seen a 
case, except occasionally in a woman, which 
did not have a history of excessive tobacco 
use. It is significant, too, that a boy always 
starts smoking before he starts drinking. If 
he is disposed to drink, that disposition will 
be increased by smoking, because the action of 
tobacco makes it normal for him to feel the 
need of stimulation. He is likely to go to 
alcohol to soothe the muscular unrest, to blunt 
the irritation he has received from tobacco. 

From alcohol he goes to morphine for 
the same reason. The nervous condition due 
to excessive drinking is allayed by morphine, 
just as the nervous condition due to excessive 
smoking is allayed by alcohol. Morphine is a 
legitimate consequence of alcohol, and alcohol 
is the legitimate consequence of tobacco. 

The man predisposed to alcohol by the 
inheritance of a nervous temperament will, 
if he uses tobacco at all, almost invariably 
use it to excess. And this excess creates a 
restlessness for which alcohol is the natural 
antidote. The experience of most men is that 
if they take a drink when they feel that they 
have smoked too much, they can at once begin 
smoking all over again. For that reason the 



BEEAKING BARLEYCOKN'S BONDS 131 

two go together, and the neurotic type of man 
too often combines the two. 

So, in dealing with alcoholism, the results 
are not so good if the patient does not 
give up tobacco. Only a man of the strongest 
character will persist in abstaining from alco- 
hol unless he also abstains from tobacco, even 
after he has undergone the most intelligent 
medical treatment, for the physiological action 
of tobacco is to create muscular (motor) 
unrest. 

Most habitual smokers consume every day 
more than enough tobacco to carry them be- 
yond the point where its stimulating effect 
ends and its narcotic effect begins. Where 
this habitually occurs, the definitely toxic effect 
is notable. This results in a demand for that 
stimulation which the tobacco itself once fur- 
nished but now does not. Here is an evil 
effect of the combination of tobacco and alco- 
hol that is rarely understood, and almost never 
admitted. 

So get rid of the tobacco habit if you would 
get rid* of the alcohol habit, for they fit to- 
gether and complement one another like the 
tactile fingers and thumb of a pickpocket. 

In this connection, also, I wish to empha- 
size that there is nothing which can be "dropt 



132 HABITS THAT HANDICAP 

into the coffee/ ' administered in the food, 
or introduced into the system in any secret 
way that is of the slightest avail in the relief 
of alcoholic addiction. There is absolutely no 
treatment that can be given " without the pa- 
tient's knowledge' ' that is of the slightest value, 
for cooperation is required, the physical sys- 
tem must be tuned up, and the alcohol sickness 
corrected, so that later the victim may refrain 
from drink or have the moral courage to flee 
temptation. 

This is the indispensable thing — coopera- 
tion ; without it nothing can be done, for noth- 
ing nor nobody can relieve an alcoholic of 
his craving and his habit if he does not want 
to be relieved. I can not too strongly, nor 
too repeatedly, emphasize this fact. 

The possibilities of medical help for the 
alcoholic have been exhausted when the patient 
has been freed from the effect of his stimulant 
and put in a physical condition wherein he 
feels no need for alcohol. 

But, after all is said and done, whether the 
treatment extends over six days, six weeks or 
six months, nothing except a man's own mind 
and soul can ever relieve him of the danger 
of a relapse into alcoholism. 



BEEAKING BABLEYCOBN'S BONDS 133 

It is true that a definite medical treatment 
is the intelligent beginning of help. But no 
medical treatment, no matter how successful, 
can compass that victory which a man must 
himself ultimately will to win. 



The Sheep and the Goats 

It is a bard thing to say, and a more dis- 
appointing thing to realize, but there are men 
— scores of thousands of them — whom it is 
the veriest waste of time and effort to try to 
retrieve from addiction. 

These men are hopeless — abjectly hopeless. 
Their moral fiber is a thing of shreds and 
patches: in their twisted souls they do not 
want to be helped. And no human agency can 
help a man who does not want to be helped. 

But how are we to tell when a man is or 
is not worthy? How are we to distinguish 
between the sheep and the goats? 

The most simple expedient is to find out 
what the man himself is willing to do in 
return for help. 

Now, no man of sufficient mental fiber to 
make helping him of any actual value is will- 
ing to accept charity. Even if he finds him- 
self at the moment unable to repay the debt 
involved, he will be anxious to make it a 

134 



THE SHEEP AND THE GOATS 135 

future obligation. My eighteen years of ex- 
perience have proved to me that this sense of 
personal obligation is perhaps the most im- 
portant element in the matter. 

Even when it becomes necessary for a 
relative, employer, or friend to assist a patient 
by the payment of his bills, it should be re- 
garded a part of the treatment to consider this 
a loan which must be repaid, not a gift. 

It follows, sadly enough, that the most hope- 
less alcoholic is the rich young man to whom 
financial obligations incurred for treatment 
mean nothing whatsoever, and to whom re- 
sponsible employment is unknown. Indeed, it 
seems well-nigh impossible to reform the 
vagrant rich. Also, the man who thinks that 
giving up his alcohol is essentially a priva- 
tion, even tho he may admit the definite neces- 
sity for this privation, is not likely to reform 
permanently. 

The vagrant poor are equally hopeless, for 
most of them are apathetic, chronically dis- 
couraged, undernourished, and permanently in 
that condition of mental, moral and physical 
instability that has melted whatever starch 
they may ever have had in their spiritual 
backbones and left them spineless, drifting 
jelly-fishes. Unless, first, their economic and 



136 HABITS THAT HANDICAP 

environmental conditions can be changed, these 
people promise absolutely negative results. 

So lack of occupation, either from being 
too rich or too poor, is one of the greatest of 
all hardships in the successful treatment of 
addiction. 

But be he rich or poor, there is hope for 
the man who declares that drinking is a bad 
business and that he wishes to be helped to 
stop it. This man has pride and stamina, and 
I can not say with too much emphasis that 
self-respecting pride is the main hope of the 
alcoholic. 

It must not be overlooked, however, that 
frequently it is the pride of the curable alco- 
holic which makes him difficult to reach. To 
try to help such a man when it is too late 
is a pitiably usual experience, for not until 
it is too late does his pride allow him to 
apply for help. 

The man who says "I will not drink to- 
day," and finds himself compelled to, who 
promises himself, but can not keep his promise, 
is the man who most deserves help and is 
most likely to yield some sort of good return 
on an investment made in him. Indeed, it is 
the rare alcoholic, curable or incurable, who 



THE SHEEP AND THE GOATS 137 

of his own initiative submits himself to treat- 
ment. 

Friends must assist, but while the impor- 
tance of such friendly service can not be over- 
estimated, it must be of the right kind, or it 
will be worse than useless. Friends of alco- 
holics too often either sentimentalize or bully, 
when they should go about the task of helping, 
or else they allow too little time for the accom- 
plishment of the reform. 

Again, thousands of decent men annually 
yield to alcohol, and are wrecked by it. The 
worthy and potentially valuable citizen who 
through overwork, worry, sickness, sorrow, or 
even through a mistaken conception of social 
amenities or duties, drifts into excessive alco- 
holism, is a victim of our imperfect social 
system. He quite generally repays remedial 
effort. 

Furthermore, such a man is almost invari- 
ably savable if he himself applies for salva- 
tion, assists with his own will in its applica- 
tion to his case, and pays his own money for 
the treatment. 

It seems impossible, however, to arouse any 
enthusiasm or sympathy for the human dere- 
lict whose natural weakness is inevitably such 
that one taste of alcohol leads to a gallon, and 



138 HABITS THAT HANDICAP 

final wreck and ruin. The human cipher, plus 
alcohol or minus alcohol, remains a cipher. 

For if he has achieved nothing up to the 
point where he has become addicted to ex- 
cessive alcoholism, he will rarely repay the 
trouble involved in an effort to preserve him 
from his folly, altho, of course, his preserva- 
tion from it might be of general social serv- 
ice as a means of saving the public money 
that otherwise might be expended in the repa- 
ration of the results of his destructive ten- 
dencies, besides the public expense involved 
in police, court and prison charges that result 
from his self-indulgence. 

Nor is the colonization of the addict more 
effective, except for the hopeless cases. It 
means segregation. A man once said to me: 
"I want to be helped, but not at the cost of 
compulsory association with others seeking 
help. I know that to be thrown into unavoid- 
able contact with those worse than myself 
would hopelessly degrade me. I should not 
be willing to risk that, no matter how much 
good the treatment might do me." 

Colonization of the occasional alcoholic 
stamps him only a little less deeply than his 
stripes are sure to stamp the criminal who is 
sent to prison, and its effects upon him and 



THE SHEEP AND THE GOATS 139 

his family are hardly less injurious than would 
be the effects of punitive incarceration. 

Also, he is likely to be barred from employ- 
ment after his discharge from the colony, and 
thus find it impossible to reestablish himself. 

Moreover, during the period of sequestra- 
tion, it is difficult to devise a plan for the 
care of the wives and children of those sent 
into seclusion. At a time when nothing in 
the way of betterment can be expected of 
him until he regains confidence in himself, 
such treatment only serves to cripple a man's 
spirit. 

Colonization of the hopeless is advisable 
only because such men, before they have des- 
cended to that stage, have cost their friends 
and society all that it is advisable to spend 
on them. If the man who is worth while is to 
be saved, it must be without the application 
of the brand. 

And in this connection it may be well to 
note that temporary colonization in sanitaria 
is open to similar objections. Picture to your- 
self a group of from half a dozen to fifty drug 
or alcohol patients, eating together, walking 
together, sitting on the veranda together day 
in and day out. In this group may be repre- 
sented many different temperaments and many 



140 HABITS THAT HANDICAP 

different stations of life, from the gambler 
to the clergyman. 

Thus, in a matter where individual and iso- 
lated treatment is imperative, sanitaria or 
colonization deal with patients collectively. 
And whatever moral restraint the habit has 
left in a man tends to completely relax when 
he hears constant bragging of trickery and 
evasion and has learned to envy the clever- 
ness and resource so exhibited. The self- 
respect and pride which must be the main 
factors in his restoration may become fatally 
weakened. Therefore colonization should be 
restricted to the hopeless cases, and to them 
only because it is unhappily necessary. 

Also drug-users, as well as alcoholics, who 
are sent, officially or otherwise, to institutions 
of this character, are too often prone to be- 
come "sanitarium convicts." Their cases are 
hopeless, and but little less pitiable than that 
of a "lifer" in prison. 

As to the various classes of drinkers, and 
the comparative possibilities of treating them 
successfully, I must in all frankness say that 
it has been my experience that the occasional 
drinker, the steady drinker, the social drinker, 
or the still drinker, are all practically in one 
class, so far as reclamation is concerned. It 



THE SHEEP AND THE GOATS 141 

is the human equation, not the character of 
the addiction, that decides the issue. 

Most alcoholic patients need physical care 
and attention after their alcohol is eliminated. 
We find that back of the taking of alcohol 
there may be a run-down, depleted nervous 
system, perhaps with blood disease of some 
kind, or with some other physical troubles. 
In every case there should be a most careful 
accounting of the whole physical man as well 
as of the mental man. 

A man with an alcoholic history who is 
not yet physically able to work without feel- 
ing extreme fatigue should be carefully safe- 
guarded. Unless he has genuinely made up 
his mind never to touch stimulants again, 
there is a possibility of relapse, even tho 
there would be no direct physical craving for 
alcoholic stimulants. Discouragement, or 
weariness, may " knock him out." Such pa- 
tients should, if possible, avoid doing anything 
that would set up a nervous condition, or 
that would, for any reason, make them feel 
a need of alcoholic stimulation. 

Again, every able-bodied man who can work 
and won't work should be made to work; and 
State and municipal authorities the country 
over should provide ways and means by which 



142 HABITS THAT HANDICAP 

such men should be forced to work, and to 
work at something worth while. If these 
authorities could bring influence to bear on 
some of the heads of leading industrial con- 
cerns, and have them outline ways and means 
by which those men who now constitute human 
waste could be employed, it would mean the 
clearing up of the worst phase of this alco- 
holic situation in a very short time. 

Not only should these men be employed in 
work which would mean the making or manu- 
facturing of something that was needed and 
was well worth while, — work which would also 
be reasonably well recompensed, — but also 
there should be some way whereby those who 
have not been especially trained industrially 
could be taught some profitable trade. 

The only way to begin to make the authori- 
ties realize fully their responsibility in this 
matter is, so it seems to me, to pass such laws 
as shall for the first time require them to 
deal with this subject intelligently; to make 
the large municipalities establish each an alco- 
holic clearing-house; to make each State set 
aside one institution for the convenience of 
those who would not be eligible for treatment 
in the municipal institutions; to make an in- 
telligent classification of all alcoholics, and to 



THE SHEEP AND THE GOATS 143 

outline to the different magistrates and police- 
courts the proper course to pursue in deal- 
ing with alcoholics. 

The courts and the police should have defi- 
nite instructions as to what disposition to 
make of this type of unfortunate. The wards 
of hospitals receiving such patients should, 
in every instance, avoid unnecessary coloniza- 
tion. There should be some means of identi- 
fication of such cases in the public institu- 
tions, and there should be a final disposition, 
one way or another, of the confirmed alco- 
holic. 

At present the authorities, with too few 
exceptions to mention, have no concern what- 
ever for the alcoholic patient. They don't 
know what on earth to do with him or for 
him — and they do it! 

And, finally, there is not going to be much 
satisfactory history written in dealing with the 
chronic alcoholic. Any progress toward real 
results on this subject is going to come from 
the younger generation of human beings, who 
are innocent of alcoholic saturation. 

I would like to see, as a part of the curri- 
culum of every public and private school in 
this country, enforced study of what drugs, 
alcohol and tobacco really mean in their ef- 



144 HABITS THAT HANDICAP 

fects on the human system. I would not 
show any horrible pictures; I would just tell 
the plain story as it really is. The plain 
story is bad enough. And not until such 
education has been given will there be any 
real progress made in removing this curse. 



XI 

Poisostiitg Nekves with Nicotine 

In the Fifth Edition of the National Dis- 
pensatory, on page 1576, there is a bald 
statement of a fact. This fact is that "Nico- 
tine stands next to prussic acid in the rapidity 
and energy of its poisonous action. " 

Prussic acid is probably the most deadly 
of all known poisons. A drop placed on the 
tongue kills like a stroke of lightning. 

Here are facts which, if realized by the 
good men and women who, during the late 
war, worked so faithfully to "get smokes to 
the boys," might give them pause, for scores 
of thousands of these fine young chaps have 
been, and are being, killed by the kindness of 
these well-meant efforts. 

Many of them have been so thoroughly 
nicotine-soaked that, medically speaking, they 
may be properly classed as invisibly wounded 
men, along with the shell-shock cases and 
other forms of neurosis. 

Their livers, kidneys and other vital organs, 

145 



146 HABITS THAT HANDICAP 

the activities of which keep the blood free 
from poisons, have been permanently dam- 
aged by continuous overwork against narcotic 
intoxication. 

The elastic tissues of their blood-vessels, 
because of the increased tension placed upon 
them by the poisons of tobacco, have lost 
elasticity. Their hearts have become degen- 
erated by the abnormal pressure of their dis- 
eased blood-vessels. They have sown the seeds 
of Bright 's Disease, apoplexy, and " heart 
failure/ 9 seeds which will inevitably bear 
fruit in their early dissolution. 

Now, tobacco and the potato are blood 
brothers in the family of plants. But tobacco 
is a beetle-browed criminal — a black sheep in 
an honest family that causes the mild-eyed 
potato and her other starchy relatives to hang 
their heads in shame over the stigma in this 
classification. 

The delightful dolce far niente of tobacco, 
so^ loved of those who welcome the solace of 
the "drug," is merely a stupor, the easeful 
sedation of a poison harmful to our physical 
welfare, depressing to our nervous system 
and destructive to our moral tone, particu- 
larly in the immature. Nicotine is a drug 



NICOTINE-POISONED NERVES 147 

the effects of which can not be guaranteed 
under the pure man law. 

No matter what may be said by enthusiasts 
and apologists, there is not, so far as any 
scientific investigation can determine, the 
slightest reason why, from a standpoint of 
health or efficiency, any one should ever use 
tobacco. 

The stimulating effects on the brain are 
evanescent and transient. The real effects 
are uniformly narcotic and deadening. 

Practically all medical men agree that the 
excessive use of tobacco is dangerous. First, 
the smoke itself — by reason of the ammonia, 
carbon and carbonic-acid gas which it con- 
tains — is irritating to the respiratory mucous 
membrane, setting up a chronic catarrh or 
some other sub-acute inflammatory process; 
next, the fine particles of carbon settle in the 
throat or in the lung-cells, causing irritation 
and "shortness of breath"; then the ammonia 
"bites the tongue," drys the throat, and also 
has a deleterious effect upon the blood. The 
carbonic-acid gas in the tobacco-smoke pro- 
duces dizziness, headache, and lassitude — 
permanently subsiding only with the removal 
of the cause. 

Also, nicotine, which is absorbed from the 



148 HABITS THAT HANDICAP 

end of the cigar or from the oil and water 
in the stem of the pipe, is a powerful nar- 
cotic poison. One drop, placed on the tongue 
of a dog (so we are told) will kill him 
"deader than a door-nail." In fact, if the 
nicotine contained in a single cigar were 
dissolved out and injected hypodermically 
into a human being who had not established 
tolerance for the drug, it inevitably would 
prove fatal. 

The percentage of nicotine varies with the 
kind of tobacco and with the district in 
which it is grown. 

Our domestic "cabbage-leaf" brand con- 
tains from .94 to 5 per cent, of nicotine. 
This is on the authority of the U. S. Depart- 
ment of Agriculture. The French Depart- 
ment of Agriculture states that it finds from 
.22 to 10.5 gr. in tobacco examined by their 
experts. 

In addition to the nicotine, the tobacco con- 
tains small quantities of substances similar 
in composition, such as nicotellin, nicotein, 
and a substance related to camphor called 
nicotianin. It is to this drug, as well as to 
a volatile oil developed during the process 
of preparation, that the characteristic flavor 
of tobacco is largely due. 



NICOTINE-POISONED NEEVES 149 

Notwithstanding the opinions generally 
held concerning the " strength " of Havana 
cigars, in reality they contain far less nico- 
tine than do the cheaper brands. 

This may be a source of gratification to 
the average man, who has all the satisfac- 
tion of knowing that, even if he hasn't as 
much money to spend for his cigars, never- 
theless he can get more actual poison out 
of his expenditure, dollar for dollar, than 
does the millionaire clubman. 

It may here be noted that nicotine itself 
is not found in smoke, as it is changed by 
combustion into pyridine, collidine and preo- 
lin, as well as other bases. Still these sub- 
stances retain, in a degree, practically all the 
depressive qualities of their volatile ancestor. 
Also, the heavy odor of dioxide or carbon 
is very unhealthful and obnoxious, even to 
smokers themselves. 

There is also an appreciable quantity of 
carbolic acid, marsh gas, cyanogen and hydro- 
cyanic acid in the smoke of tobacco. 

There certainly isn't anything very appe- 
tizing or inviting in this formidable list of 
poisons that should stimulate glad halle- 
luiahs and hosannas from the multitude of 
Lady Nicotine's devotees. 



150 HABITS THAT HANDICAP 

But where ignorance is bliss, 'tis folly to 
be informed. And the sum total of ignor- 
ance on the subject of tobacco, its ingredients, 
and its effects, is nothing short of Gibraltaic. 

Some there are who contend that there can 
be no danger from nicotine and the by-prod- 
ucts of tobacco in the smoke, for these are 
destroyed in the process of combustion. This 
tribe of advocates blames any deleterious con- 
sequences that might result from smoking 
upon the development of decomposition prod- 
ucts from the burning tobacco, particularly 
pyridin. 

But pyridin is also produced when cabbage 
or corn leaves are burned. And there is no mad 
desire apparent on the part of the populace to 
indulge in the smoking of cabbage leaves or 
corn husks. 

However, it is admitted by competent 
authorities that there is a certain proportion 
(estimated at about 30 per cent, by the U. S. 
Department of Agriculture) of nicotine in 
tobacco smoke. And it is quite likely that 
this and the poisonous effects it produces 
on the organism are the real reasons why 
smoking is so wonderfully popular. 

The inhalation of tobacco smoke and the 
absorption of toxic by-products into the cir- 



NICOTINE-POISONED NERVES 151 

dilation through the two thousand square 
feet of lung air-cell surface also arrests oxi- 
dation. Like alcohol, opium, and other nar- 
cotic drugs, tobacco retards the burning up 
of dead tissue. It prevents cell metamor- 
phosis, and consequently impairs nutrition; 
for, in perfect metabolism, it is as essential 
to get rid of dead material as it is to build 
living structures. And, further, we can not 
build living structure until the debris of the 
worn-out cells has been removed. This ex- 
plains why the use of tobacco in growing 
boys is most injurious; it stunts them, men- 
tally and physically, and lays the foundation 
for the acquirement later of pernicious and 
reprehensible habits. 

Next, the excessive use of tobacco unduly 
stimulates the nervous system and the action 
of the heart. When the products of cell 
decay are stored up in the tissues, the heart 
automatically pumps faster, in the effort to 
oxidize an excessive amount of fatigue-poison 
generated by violent exercise. The heart is 
endeavoring to bring to the cells sufficient 
oxygen to burn up and convert their meta- 
bolic poisons; that is, the poison developed 
in the repair and destruction of cell tissue. 
Vital energy is dissipated, for which there is 



152 HABITS THAT HANDICAP 

no compensatory return. If this is long con- 
tinued the heart weakens, loses the regularity 
of its rhythm, or even " skips' ' an occasional 
beat. In addition, it contracts more rapidly, 
and with unnecessary force, and then we have 
the serious state known as "smoker's heart." 
If the cause is not removed, the smoker will 
keep on "skipping," getting progressively 
worse, as the condition develops from func- 
tional into organic, and eventually he will 
skip into another land — where there is noth- 
ing else to do but smoke. 

Sometimes, even tho the patient reforms 
and gives up entirely the use of tobacco, the 
rapid heart action and irregularity induced 
by his former excessive smoking will be per- 
manent. A friend of mine has one of these 
reformed-smoker's hearts of twelve years' 
standing, and bids fair to keep it for forty- 
eight more — if he lasts that long. 

Excessive use of tobacco, to many indi- 
viduals, impairs the memory. It creates a 
sluggishness and apathy that reflect them- 
selves in mental incorrelation — in an inhibi- 
tion of the association impulses. It is as- 
serted that in a period of more than fifty 
years no inveterate user of tobacco has ever 
carried off the first prize at Harvard College; 



NICOTINE-POISONED NEEVES 153 

and this is corroborated by the experiences 
of other schools where records have been 
accurately kept. 

Here are a few of these records of unques- 
tioned authenticity: 

Dr. Edwin C. Clarke studied two hundred 
students of Clark College and found the 
scholarship distinctly lower among the smok- 
ers than among the non-smokers. 

Dr. George L. Maylan, of Columbia Uni- 
versity, found that the ratio of failures of 
smokers as compared to those of non-smokers 
was ten to four. 

In the study of eight hundred high-school 
boys, Dr. P. E. Henry found a school record 
difference ranging from 17 per cent, to 28 
per cent, in favor of the non-smokers. 

Those who believe that they think more 
clearly while under the influence of tobacco 
probably actually do think better, but this is 
because of the fact that the system has ac- 
customed itself to tobacco — that a certain 
amount of the drug is necessary to restore 
what to them is a normal condition. Just 
as the alcohol-saturated cells of an addict 
cry out for sufficient alcohol to permit them 
to function normally to their acquired patho- 
logical habit, so the nerves and cells of a 



154 HABITS THAT HANDICAP 

constant tobacco user demands a certain 
amount of nicotine, in order to relieve ab- 
normal nerve and body tension. It is be- 
cause the tobacco addict is not compelled to 
think about how badly he wants his smoke, 
that he thinks better when he has it. 

All college men — and even most school- 
boys — know that, from the moment they 
begin training until they " break' ' again, the 
use of tobacco is absolutely interdicted. Ex- 
perience has demonstrated that the "wind," 
digestion and heart are powerfully and un- 
favorably influenced by its use. No athlete 
who is called upon to expend his last atom 
of strength, skill or endurance in friendly 
contest can afford the almost certain decrease 
in strength and skill or weakening of heart 
and "wind" which trainers know will inevit- 
ably follow dalliance with nicotine. 

Dr. Frederick J. Pack studied two hundred 
and ten men who contested for position on their 
college athletic team. Ninety-three were 
smokers ; one hundred and seventeen were non- 
smokers. The non-smokers surpassed the 
smokers, with a difference of 32 per cent. 

Dr. Pack also made inquiry as to this ath- 
letic situation in fourteen other universities, 
and learned that the non-smokers won, with 



NICOTINE-POISONED NERVES 155 

12 per cent, in their favor. He also found 
against the smokers, low scholarship, small 
lung capacity, and a uniformly low degree of 
success in "making the team." 

Prof. Jay Seaver, of Yale University, like- 
wise reports a decidedly impaired lung capac- 
ity on the part of the habitual smoker. 

Tobacco undermines will-power and predis- 
poses to alcoholic excesses. It is maintained, 
by specialists in the treatment of drug and 
alcohol addiction, that the dipsomaniac whose 
periodic debauches seem to occur without 
rhyme or reason are victims of chronic to- 
bacco poisoning, and that this poisoning is 
really the fundamental cause of their periodic 
inebriety. This is particularly true of cigaret- 
smokers and pipe- or cigar-smokers who "in- 
hale" the tobacco smoke. 

The explanation is that those patients smoke 
themselves beyond the sedative stage and into 
a state of nervousness, then increase their 
smoking in a vain attempt to gain sedation. 
Finally they become so nervous through to- 
bacco excesses that they require a narcotic 
to quiet them, when they turn to our old 
friend, John Barleycorn. Their jaded and har- 
rassed systems are exceedingly intolerant to 
alcohol, for, after the first drink, they are 



158 HABITS THAT HANDICAP 

mentally "over the way." They then decide 
that they might as well be drunk as be the 
way they are, so they go to the full spree. 

With few exceptions, the vicious cycle can 
be broken only by those men quitting tobacco. 
Unless this is done, they will continue to use 
— or rather abuse — both alcohol and tobacco. 
They can not stop drinking — and this is worth 
noting — they can not stop drinking, unless they 
first give up smoking. 

Next — and this is interesting to the middle- 
aged who are developing a little blood tension, 
or whose arteries are losing elasticity— it has 
been shown that tobacco aggravates, if it does 
not cause, arteriosclerosis. This is owing to 
the stimulating effect upon the adrenal glands 
— those little bodies that sit like caps on the 
tops of the kidneys, and whose function is so 
obscure and complex. These glands, when 
overstimulated, secrete an abnormal amount 
of adrenaline into the circulation, which, on 
its part, in some inscrutable way has the effect 
of increasing blood tension and hardening the 
arteries. 

Also every eye-specialist has seen cases of 
toxic amblyopia (weakness of vision produced 
by poisoning), paralysis of the optic nerve, 
or even optic nerve atrophy (a destruction 



NICOTINE-POISONED NEEVES 157 

of the nerve-cells and their replacement by 
dense connective-tissue growth), which origi- 
nated in the excessive use of tobacco. Unless 
the habit be stopt, the patient frequently goes 
to complete blindness; and with this harden- 
ing, even tho smoking be stopt, he goes any- 
how. 

Frequently there is an irritable effect upon 
the mucous membranes of the eyes resulting 
directly from the tobacco smoke, correctible 
in no other way than by mitigating or entirely 
relinquishing the habit which produces the 
trouble. 

This catarrhal condition frequently involves 
also the nose and throat, and even, in rare 
cases, the ear. 

It is not at all unusual for the mucous mem- 
brane lining of the stomach to be affected by 
the poisons of tobacco. Acid dyspepsia is com- 
monly met with among smokers. 

Also, almost every honest smoker will confess 
to the insomnia-producing effects of tobacco. 
This is so universally recognized that sophisti- 
cated smokers are always careful to regulate 
the amount of smoking they may do late at 
night. 

If they step over the line and indulge in an 
extra cigar or two during the evening, they; 



158 HABITS THAT HANDICAP 

pay the penalty of their dereliction by lying 
awake half the night, awaiting the quieting 
of their pounding pulses before fugitive sleep 
visits their tired eyes. 

Lady Nicotine's favorite method of winning 
young boys is to break down their will power. 
A typical boy "fiend" will lie, steal, and in- 
dulge in the most depraved and unnatural acts. 
In fact, the first step in the making of a "bad 
boy" is to teach a good boy to smoke, espe- 
cially cigarets. From this humble but effect- 
ive beginning, he may be depended upon to 
gravitate to liquor, "gangism," and most of 
the crimes that may ultimately land him in 
a reform-school or the penitentiary. 

Cigaret smoking is infinitely more pernicious 
than drinking, for the drink habit in boys is 
readily curable, while the cigaret habit is but 
seldom eradicated. In fact, this habit is far 
more injurious than is any other form of 
tobacco addiction, unless it be chewing; for 
the by-products produced by combustion of 
cigarets are even more deadly than are the 
nicotine by-products. 

Among these cigaret by-products (in addi- 
tion to those of the nicotine group) we have 
furfurol, one of the aldehydes (an alcohol 
deprived of its hydrogen) said to be fift$ 



NICOTINE-POISONED NEEVES 159 

times as poisonous as ordinary alcohol. Fur- 
furol is the ingredient in fusel oil which 
makes poor whisky even poorer than it ordi- 
narily might be. It is claimed that there is, 
in one cigaret, as much furfurol as there is 
in two glasses of ordinary whisky. 

This is the drug which is chiefly to blame 
for tremors, twitchings, and transient irrita- 
tions, and which explains very consistently the 
characteristic handwriting of the cigaret fiend. 
In its cumulative and long-continued effects, 
it causes both true and hystero-epilepsy, also 
muscular paralysis. 

Another member of the malodorous family 
of aldehydes found in cigarets is acrolein (or 
acrylaldehyde, for short), an intensely stimu- 
lating drug with a decidedly depressing after- 
effect. "When furfurol and acrolein are in- 
haled (the smoke percolating through the lung- 
cells), they cause a general irritation followed 
by narcosis, and by their continual use the 
nervous system is shattered. 

Hudson Maxim, in a series of tests, found 
that, owing to the loose construction of the 
cigaret the poison known as carbonic oxide 
is produced in its combustion. Maxim believes 
that this poison is responsible for the demoral- 
ization of the cigaret fiend. "The cigaret can 



160 HABITS THAT HANDICAP 

burn only poisonously," he declares. And as 
a poison producer, it is in a class by itself. 

Many varieties of cigarets are " doped' ' ex- 
pressly to allay nausea, which is the normal 
effect of tobacco smoking upon the uninured 
human system, and at the same time quiet 
that motor unrest which is the first symptom 
to follow the introduction of nicotine into the 
human system. The narcotic effect of the 
adulterant drugs is, therefore, to ease the 
smoker's first pang, and to make him more 
quickly the victim of the tobacco habit. 

"While authorities differ as to the probabil- 
ity of cancer developing as a result of smok- 
ing, there is absolutely no doubt that lip- 
cancer (epithelioma) and cancer of the tongue 
and the throat have been traced to the irrita- 
tion of the pipestem or the hot acrid smoke. 

Umberto Sorrentino, the Italian concert- 
tenor, has pointed out that tobacco is a stran- 
gling clutch on the throats of most singers and 
speakers, depositing, as it does, irritating and 
" drying' ' particles of carbon in the resonance- 
chambers of the nose and oral cavity and 
inflaming the delicate vocal chords and larynx 
with its acridity. 

"We can also say, with comparative certainty, 
that functional derangements of the digestive, 






NICOTINE-POISONED NERVES 161 

nervous and circulatory systems (manifested 
in headache, lack of appetite, dyspepsia, 
nausea, lassitude, lack of concentrative power, 
confusion of mind, indisposition to muscular 
effort, incoordination and insomnia) frequently 
follow our treading the primrose paths hand 
in hand with Lady Nicotine. 

To the average man, the habit of snuffing 
seems most peculiar — one, apparently, with- 
out reason. There is, however, an appreciable 
amount of stimulus from the local action of 
tobacco upon the nasal mucous membrane. 
Snuffing is really a sort of homeopathic chew- 
ing. 

Except among the more ignorant of South- 
erners, the practise of dipping a small brush 
or roughened stick of wood into tobacco and 
rubbing it on the gums or mucous membrane 
of the mouth is now almost obsolete. This 
manner of using tobacco produces a powerful 
excitation upon the nervous system. Also 
partaking blithesomely of an infusion or de- 
coction of tobacco is a custom that now happily 
is honored more in the breach than in the 
observance. 

With the cost of the tobacco habit we are 
not here concerned. If it helps, it is — like 
anything else that is helpful — worth all it 



162 HABITS THAT HANDICAP 

costs. Figuring that if one saved his cigar- 
money for sixty years, he would have enough 
laid aside to put a new tin roof on the barn, 
or to repair the automobile, doesn't "get any- 
where/ ' or convince any one. 

"We do accomplish something definite, how- 
ever, if we can prove — as did Ceisne, a French 
physician — that among thirty-eight boys be- 
tween nine and fifteen years of age, in twenty- 
two there were marked circulatory disturb- 
ances and heart palpitation; in thirteen inter- 
mittent pulse; in six, decided anemia; several 
suffered from nosebleed, insomnia and night- 
mares; four had ulcerated mouths; and one 
had consumption; all as a result of tobacco 
addiction. 

Further, if we show that eleven of those 
thirty-eight boys were induced to quit the use of 
tobacco and within six months were completely 
restored to health, we accomplish still more. 

Accurate statistics are not obtainable as to 
the influence of tobacco in causing insanity, 
altho many of the world's greatest authorities 
on mental diseases are convinced that it is a 
predisposing factor in a large percentage of 
the victims. There is no doubt that in the 
presence of an unstable nervous organism, 
nicotine is extremely detrimental. 



NICOTINE-POISONED NEEVES 163 

Dr. Bancroft, of the New Hampshire Asylum 
at Concord, writes in no uncertain terms on 
this matter. He says: "I have known several 
cases of insanity, most unquestionably pro- 
duced by the use of tobacco, without other 
complicating causes." 

Dr. L. Pierce Clark, speaking on the effects 
of tobacco on the mind, says: " Fully half the 
patients who come to our asylum for treat- 
ment are victims of tobacco." 

The Superintendent of the New York Insane 
Asylum holds that "tobacco has done more to 
precipitate minds into the vortex of insanity 
than spirituous liquors." 

Life-insurance companies also have ne- 
glected a very fertile field for investiga- 
tion in not obtaining more definite actuary 
and mortuary statistics relating to tobacco 
users by listing smokers and non-smokers 
separately, as many now do with drinkers. 
One New York company (The Postal Life) is 
taking this matter up, and in a recent bulletin 
it said: "We believe the attitude of the medi- 
cal profession is rapidly changing toward to- 
bacco, as it has changed toward alcohol." 
"Which would indicate that this company has 
reason to regard tobacco as definitely injuri- 
ous to the human organism. 



164 HABITS THAT HANDICAP 

Dr. D. H. Bobbins, for forty years an insur- 
ance examiner, in speaking of the pernicious 
effect of cigaret smoking on the body, said 
that one-half of the tobacco users he examined 
were perceptibly injured by it, and at least 
one-eighth had irregular or intermittent valvu- 
lar action, commonly known as "smoker's 
heart." He said: 

"This weakened condition of the human 
pump allows slight regurgitation of blood 
through improperly closed valves, preventing 
complete oxidation in the lungs, thereby re- 
taining the poisonous gases in the system, and 
eventually resulting in dropsy or some other 
systematic breakdown." 

We are in the habit of looking to the insur- 
ance companies for accurately tabulated infor- 
mation in vital statistics: we might recom- 
mend this subject to their further attention. 

It is a great pity that experiments of an 
exhaustive and convincing nature have not yet 
been attempted with tobacco, to determine, by 
instruments of prevision, just what degree of 
deterioration, if any, follows its use. It is to 
be hoped that scientists, such as Professor 
Chittenden and Doctor Mendel, and others in- 
terested in physiological or psychological 
research work, will undertake experiments like 



NICOTINE-POISONED NEEVES 165 

those made by Professor Kraepelin with al- 
cohol. 

These investigators might set aside a squad 
of, say, ten men who can stop smoking for a 
period, and at the start ascertain their maxi- 
mum capacity for work, by means of the ergo- 
graph, " writing-balance/ ' memory, adding and 
subtracting tests, and whatever else may ap- 
peal as interesting and conclusive. Then these 
same men should smoke or chew a definite 
amount of tobacco each day, and be subjected 
to the identical experimental tests, tabulating 
the results and comparing them with the pre- 
ceding tests. 

It would be interesting to try out the squad 
also on the hurdles, the track, the blowing-, 
punching- and striking-machines, "chinning 
the bar," dumb-bells, weight lifting, standing 
on one foot, or whatever else might serve to 
demonstrate muscular vigor and coordinate 
power: and then compare the before- and the 
after-results of this work. These experiments, 
if the results of the tests bore out clinical 
findings, would give us a mass of irrefutable 
data extremely valuable and helpful, and 
which, incidentally, would make very interest- 
ing reading. 

But while we do not yet know the exact 



166 HABITS THAT HANDICAP 

amount of physical and mental deterioration 
produced by the use of tobacco, we do know 
what some of the largest employers of labor 
think of the matter. 

The Cadillac Motor Company, the Larkin 
Company, the Buffalo Adding Machine Com- 
pany, Marshall Field & Company, the Colo- 
rado Fuel & Iron Company, the Sharpless 
Cream Separator Company, John Wanamaker 
& Company, and dozens of other employers 
of labor, state emphatically that either they 
do not employ smokers at all or else they give 
the preference in all instances to non-smokers. 

The classic controversy between Henry Ford 
and Thomas A. Edison on the one hand and 
a certain prominent and prosperous tobacco 
company on the other hand are sufficiently 
recent to be remembered by anybody who 
really cares to remember the interesting bat- 
tle. It hardly is necessary to say that the 
tobacco company aforesaid came out of the 
fracas a very poor second best. 

Those who may care to refresh their memo- 
ries concerning this instructive melee might 
write to Mr. Ford for a copy of his illuminat- 
ing pamphlet, "The Case Against the Little 
White-Slaver." 

It may cure them of the bad habit of plying 



NICOTINE-POISONED NERVES 167 

friends with cigarets. Indeed, it may even 
cure some of them of the desire to continue 
to poison themselves by the same means. 

No doubt there is many a true word spoken 
in jest. Perhaps one of the very truest of all 
these is to characterize cigarets as " coffin- 
nails.' ' But that is exactly what they are. 

So perhaps the next great reform will be 
to effect legislation which will place all the 
States- of the United States in the same class 
as those three enlightened "Western States that 
now forbid the sale or smoking of cigarets 
anywhere within their borders. 

In the United Kingdom, the per capita con- 
sumption of tobacco is about two pounds per 
year, and has remained at about this figure for 
many years. In America the per capita con- 
sumption is about eight pounds, an increase of 
more than 50 per cent, in twenty years. 

If the present rate of increase were to con- 
tinue for twenty years longer, there would not 
be nearly enough doctors and sanitariums in 
the land to care for the victims of that fickle 
jade, Lady Nicotine, who holds the hope of 
promise to our eyes, only to break it over our 
heads and then leaves us to pick up the pieces. 

But perhaps we shall have learned something 
within the next twenty years. 'Tis a con- 
summation devoutly to be hoped for. 



xn 

Lady Nicotine and the Yotjngeb Generation- 
It 's a pretty difficult job to teach an old 
dog new tricks. And the older the dog, and 
the newer the tricks, the more difficult the job. 
This is why arguments addrest to the aver- 
age man, concerning the folly, futility and 
fatuousness of the use of tobacco, are usually 
so ineffective — why they roll from his brain 
like a bombardment of peas from the hide 
of an armadillo. 

So, if we ever hope to get the real facts of 
tobacco addiction "across," if we ever hope 
to show that the rose-scented, sense-alluring 
tales fostered by the gentlemen- who profit 
hugely from the sale of poisons are a pack of 
lies — cut out of the whole cloth — we have got 
to tell them to the still uncontaminated younger 
generation. 

In our schools, in our text-books, in churches, 
in homes everywhere, a campaign of education 
should be launched that would establish defi- 
nitely in the minds of yet-teachable youth the 
actual status of tobacco. 

For one must provide strong reasons to 

168 



NICOTINE AND THE YOUNG 169 

make a man, hardened in the art of smoking, 
give it up. He will not ordinarily do so, be- 
cause it costs him something, and he expects 
to pay for his pleasures. "When he has actu- 
ally gone to pieces it is comparatively easy 
to convince him that he should give up what is 
hurting him; but the average man has not 
been excessive enough for this, and has never 
brought himself to the point of serious con- 
scious injury. 

Even a physician can not, with any cer- 
tainty, tell the average moderate smoker 
whether tobacco is hurting him. Consequently, 
if one would make this man stop smoking, 
especially when he sees that leaving off has 
caused some people more apparent discomfort 
than was caused by all their smoking, one's 
only chance is to make him change his mental 
attitude. 

I hope to assist in doing this by calling at- 
tention to the fact that tobacco not only pre- 
pares the way for physical diseases of all 
kinds, but also, as long investigation has 
shown, for alcoholism and for drug-taking. 

But first let us consider a little further 
some of the less noxious, but equally deterring, 
characteristics of tobacco. 

When first tobacco was introduced into 



170 HABITS THAT HANDICAP 

Europe the use of it was everywhere regarded 
as injurious. On this account, its general 
adoption was slow; it was only when people 
became inured to its injuriousness that the 
habit began to spread. 

Yet even to this day we find that smokers, 
as well as non-smokers, are suspicious of any 
form of tobacco-taking to which they have 
not become accustomed. Smokers, who for 
the first time meet chewers or snuffers, or 
those who "dip" tobacco, as in the South, are 
affected unpleasantly. Smokers persist in find- 
ing chewers disgusting, and smokers of pipes 
and cigars frequently object to the odor of 
cigarets. 

Nothing more strikingly illustrates how com- 
pletely people may become addicted to a 
habit than the smoking and chewing of the 
traditional Southern gentleman of the old 
school, who would be horrified at any other 
exhibition of personal uncleanliness. 

Also, young men most fastidious about their 
apparel seem quite unaware that their cloth- 
ing is saturated with the smell of tobacco, 
and the odor of a cigaret is probably as 
offensive to some who do not smoke as is 
any other smell under heaven. 

Arguments in favor of tobacco for any 



NICOTINE AND THE YOUNG 171 

physical reason are baseless. It does not aid 
digestion, preserve the teeth, or disinfect; and 
it is not a remedy for anything. The good it 
does — and no habit can become general, of 
course, unless it does apparent good — can 
only be mental. 

Let me admit at once that smoking confers 
mental satisfaction. It seems to give one com- 
panionship when one has none; something to 
do when one is bored; keeps one from feeling 
hungry when one is hungry; and blunts the 
edge of hardship and worry — as do most other 
narcotics. And in the same way — by blunting 
nerve impulse. 

In return for this, however, tobacco stunts 
the growth— as* is proven by observations made 
over a period of four years at Yale and Am- 
herst, where it was shown that non-smokers 
increased more in weight, height^ breast-girth 
and lung capacity than did smokers during the 
same period. 

1 It is true, we are, as yet, ignorant of the 
effect of small, continued doses of the various 
tobacco poisons. All drugs comparatively 
harmless, such as lead, mercury and arsenic, 
produce a highly injurious effect when taken 
in repeated small doses. Just what effect the 
use of tobacco engenders we can not abso- 



172 HABITS THAT HANDICAP 

lutely know, but no physician doubts that 
smoking may be a factor in almost any dis- 
ease from which his patient is suffering. 

In the immature, even the moderate use of. 
tobacco not only stunts the normal growth of 
the body and mind, but also causes various 
nervous disturbances, especially of the heart 
— disturbances which manifest in later life 
only when smoking has become excessive, 
which is to say that tho a boy's stomach 
grows tolerant of nicotine, to the extent of 
taking it without protest, the rest of the body 
keeps on protesting. 

Tobacco, in bringing about a depreciation 
of the nerve-cells, brings, together with physi- 
cal results like insomnia, lowered vitality and 
restlessness and their moral counterparts, 
irritability, lack of concentration, desire to 
avoid responsibility, and an inclination to 
travel the road of least resistance. 

Cigaret-smoking is admittedly the most in- 
jurious of all the manifold ways of using 
tobacco, because the cigaret-smoker almost in- 
variably inhales. He gets* most harm merely 
because the bronchial mucous membrane ab- 
sorbs the poison most rapidly. 

Since it is a little difficult to inhale pipe or 
cigar smoke without choking, the products of 



NICOTINE AND THE YOUNG 173 

a pipe or cigar are usually absorbed only by 
the mouth, nose and throat; whereas the in- 
baled smoke of the cigaret is absorbed by the 
entire area of windpipe and bronchial tubes. 

If you wish to see how much poison you 
inhale, try the old experiment of puffing ciga- 
ret smoke through a handkerchief, and then, 
having inhaled the same amount of smoke, 
blow it out again through another portion of 
the same handkerchief. The difference in the 
discoloration will be quite obvious. You will 
note that in the second case there is hardly 
any stain on the handkerchief: the stain is on 
your windpipe and bronchial tubes. 

If a man inhales pipe or cigar smoke, he 
gets more injury simply because he gets 
stronger tobacco; but no one ever inhales the 
smoke of a pipe or cigar, unless he is a smoker 
of long standing, or unless he has begun with 
cigarets. 

Besides allowing one to inhale a cigaret 
engenders more muscular unrest than any 
other kind of a smoke. Because of its short- 
ness, cheapness and convenience, one lights a 
cigaret, throws it away, and then lights an- 
other. This spasmodic process, constantly re- 
peated, increases the smoker's restlessness, 
while at the same time satisfying it with a 



174 HABITS THAT HANDICAP 

feeling that lie is doing something. Yet, de- 
spite the fact that cigaret smoking is the worst 
form of tobacco addiction, virtually all boys 
who smoke start with cigarets. 

The universality of the habit of smoking 
tobacco is one of its most insidious features. 
It fosters, or traditionally accompanies, social 
intercourse — which makes it all the harder to 
uproot. 

What grounded opium so strongly in China 
was its social side. The Chinese lacked social 
occupation. It was not the custom of the coun- 
try for a man to find this with his friends 
and family, tho no people are more socially 
inclined. So smoking opium became their 
chief social activity, and they; gathered to- 
gether in the one heated room of the house 
to gossip over their pipes. 

"We smoke tobacco as the Chinese smoke 
opium, "for company," and in company. And 
the smoker of cigarets gets his narcotic by 
precisely the same mechanical process through 
which the opium-smoker gets his. 

The opium-smoker would find it too ex- 
pensive a process to obtain the desired effect 
from opium by taking it into his stomach. 
But by burning a very much smaller quantity 
of the drug, and bringing it into contact with 



NICOTINE AND THE YOUNG 175 

the sensitive absorbent tissues of the throat 
and nose, he obtains the craved narcotic 
result. 

I am convinced that the use of cigarets is 
responsible for the undoing of 75 per cent, 
of boys who go wrong. Boys who spend their 
time in smoking go where they will find other 
lads also engaged in the forbidden habit. 
They find congenial groups in poolrooms — 
where they learn to gamble — and in the back- 
rooms of saloons, where they learn to drink. 

The step from the poolroom or the saloon 
to other gambling places, and to drinking 
places frequented by the unworthy of both 
sexes, is an easy one. Thus the boy whose 
first wrongdoing lay in the smoking of cigarets 
soon becomes the target for all manner of im- 
moral influences. 

And this brings us to the crux of our argu- 
ment, for the more closely smoking, drinking 
and drugging are compared the more resem- 
blances are apparent. 

Opium, like tobacco and alcohol, ceases to 
stimulate the moment the effect of it is felt; 
it then becomes a narcotic. The history of 
the three poisons as resorts in emergencies 
is precisely the same. At the time when the 
average man feels that he needs his faculties 



176 HABITS THAT HANDICAP 

most, he will, if addicted to any of the three, 
deliberately seek stimulation from it. 

He does not intend to go far enough to get 
the narcotic effect, since this would clearly 
defeat his own aim. He means to stop with 
the stimulant or the sedative effect. But this 
he is unable to do. 

The inhaler of tobacco gets his effect in 
precisely the same way that the opium-smoker 
gets his — by rapid absorption through the 
tissues of the bronchial tubes. It may be news 
to most men to know that the man who smokes 
opium moderately suffers no more physical 
deterioration than the man who inhales tobacco 
immoderately. 

The excessive smoker of cigarets experiences 
the same mental and physical disturbance 
when deprived of cigarets that the opium- 
smoker experiences when deprived of opium. 
The medical treatment necessary to bring 
about a physiological change in order to de- 
stroy the craving is the same. The effect of 
giving up the habit is the same — cessation of 
similar physical and mental and nervous dis- 
turbances, gain in bodily weight and energy, 
and a desire for physical exercise. A like 
comparison, item for item, may be made with 
alcohol, but it is the similarity between to- 



NICOTINE AND THE YOUNG 177 

bacco and opium I wish here particularly to 
emphasize. 

Yet now that society has set the seal of its 
approval upon the use of tobacco by the 
women of the nation, the problem has become 
even more acute. For if the mothers of the 
land, as well as the fathers, are to poison 
their bodies and nerves with tobacco, the dan- 
gers of transmitting their instability and their 
sub-vitality are doubly acute — the blasting 
effects on the coming generation are doubly 
insured. Cigaret-smoking by women has put 
an additional handicap upon the hope for the 
future men and women of this country — al- 
ready sadly handicapped by alcohol and drugs. 

There is still another phase of the use of 
tobacco which I do not believe has yet been 
mentioned by writers on this subject. This is 
the pernicious effect of polluting with tobacco 
smoke the room in which women, children, or 
even infants, may happen to be living. 

I am reminded of this by an incident which 
occurred while I was in China. Visiting one 
day an old Chinaman in whom I was greatly 
interested, I noticed two black-and-tan dogs, 
from whose eyes a profuse lachrymal secretion 
flowed freely. The little animals were ex- 
tremely restless and irritable, running back 
and forth, and whining constantly. 



178 HABITS THAT HANDICAP 

I called the Chinaman's attention to the 
fact that the dogs acted like opium-addicts. 
The Chinaman grinned, and said, "They want 
their smoke/' 

Presently he prepared his opium, and re- 
clined on a couch to smoke it. Immediately 
the dogs jumped up on his chest and sniffed 
avidly the thick smoke the Chinaman blew 
out of his nostrils. Within a few minutes 
the dogs quieted down, all their restlessness 
gone and their tears dried up. 

I am convinced that in the same way women 
and young children become vicariously toxic 
from the tobacco smoke puffed by the men of 
the household into the air of their living 
rooms, and which they are forced to breathe. 

There is not a particle of doubt in my mind 
but that many cases of obscure nervous dis- 
orders in women and children may have their 
origin in just such practises. Indeed, I know 
personally several women who become abso- 
lutely intoxicated, and who develop violent 
headaches as a result of being forced to 
breathe the rank odors of the smoke of a 
single pipe or cigaret, smoked by some heed- 
less or selfish man, who thinks only of satis- 
fying his own toxic craving by smoking in 
the room in which his innocent victims may 
be domiciled. 



NICOTINE AND THE YOUNG 179 

I have no desire to moralize tip on the sub- 
ject of tobacco. Yet a very wide experience 
in studying the results of the use of narcotics 
has convinced me that the total harm done by 
tobacco is even greater than that done by 
alcohol or drugs. Nothing else at the present 
time is contributing so surely to the degenera- 
tion of mankind, because, while its damage is 
less immediately acute than that caused by 
alcohol or habit-forming drugs, tobacco is a 
tremendous contributory factor to the use of 
both. 

There is nothing to be said in its favor, 
save that it gives pleasure. And this argu- 
ment has; no more force in the case of tobacco 
than in the case of opium. Any man who uses 
tobacco poisons himself, and the very openness 
and permissibility of the vice serve to make 
the process of self -poisoning dangerous to the 
public as well. 

To sum up, the tobacco habit is useless and 
harmful to the man who yields to it ; it is mal- 
odorous and filthy; it is an infringement upon 
the rights and comforts of others. 

Its relation to alcohol is direct and intimate. 
Its relation to immorality, crime, degeneracy, 
disease, and death are evident to every un- 
biased student. 



18Q HABITS THAT HANDICAP 

Because of all these things, its regulation 
or prohibition may justly be claimed to con- 
stitute one of the most pressing and potent 
of all questions of this terribly poisoned era, 
and one which faces difficulties that are dis- 
couraging, if not absolutely insuperable. 



XIII 

How to Kill the Scotched Snake 

It is unfortunate that Science has moved 
hell out of the universe, for only in the hottest 
corner of hell could adequate punishment be 
meted out to the worse-than-murderers who 
enslave the souls of men and women with 
drugs. 

The Chinese, with praiseworthy intelligence, 
have set us a wonderfully inspiring example 
in providing retribution for these villains. 
They have made the illicit traffic in opium a 
capital crime — punishable by the sword of the 
executioner. If only we could follow their 
excellent example, and lop off the heads of 
a few hundred drug-peddling vultures in this 
country, we would go far to solve the problem 
that is rapidly becoming the most important 
medical and sociological question of our time. 

However, even tho we can not lay the ax 
drastically to the roots of this pestilential 
tree, there are a number of its degenerating 
branches which could be hacked off, with a 
little intelligent effort. One of these is the 

181 ! 



182 HABITS THAT HANDICAP, 

open sesame to morphine addiction by means 
of the hypodermic syringe. 

For among all the thousands of patients 
who have come to me suffering from the 
effects of morphine or other alkaloids of 
opium, 95 per cent, were started in their 
slavery by the hypodermic — not infrequently at 
the hands of a well-intentioned physician. 

In 1911 I made this statement before the 
Ways and Means Committee of the United 
States Congress, then occupied with attempt- 
ing to regulate the sale of habit-forming drugs, 
and I personally secured the passage of the 
Act by the New York legislature in February, 
1911, to restrict the sale of this instrument 
to buyers on a physician's prescription. 

Before that time all drug stores and most 
department stores sold hypodermic syringes to 
any one who had the money. A boy of fifteen 
could buy a syringe as readily as he could 
buy a jack-knife. If a physician refused to 
give an injection, the patient could get an 
instrument anywhere, and use it on himself. 

This bill has passed only a single legisla- 
ture, but I am arranging to introduce a similar 
bill before all the others, and hope to have 
the State action confirmed by a Federal bill. 

At present, even in Jersey City, or any- 



HOW TO KILL THE SNAKE 183 

where out of New York, any one may still 
buy the instrument. It is inconceivable that 
the syringe could have gone so long without 
being considered the chief factor in the pro- 
motion of a habit that now staggers the world, 
and that as yet only one State legislature 
should have seen fit to regulate its sale. 

So restricting the sale of the syringe to 
physicians, or to buyers on a physician's pre- 
scription, is the first step toward placing the 
grave responsibility for the drug habit on the 
shoulders of those to whom this blame belongs. 

"Where an opiate must be given to relieve 
pain, it should be disguised in every possible 
way. This is simple enough, for disguise can 
be practised either by giving the drug by the 
mouth or by the use of suppositories. 
I So a basic way to deal with this question 
>— to go at once and directly to the very root 
of the whole business — would be to restrict all 
use of opium to its crude form, and to its 
forms as laudanum and paregoric. This would 
cut off all pecuniary interest in the product, 
except for supplying it for legitimate medical 
needs in the crude form, and in its least harm- 
ful forms as laudanum and paregoric. 
i Crude opium contains all of the alkaloids, 
and may be taken either by the mouth or in 



184 HABITS THAT HANDICAP 

suppositories. If the traffic in and the sale 
of this drug was reduced to traffic and sale of 
crude opium, it would not inconvenience the 
medical profession in its legitimate use of 
the drug in anyway whatsoever, and it would 
immediately stop this terrifying illicit traffic 
that has grown out of the habit-forming drug 
situation. 

In 1913 I was the author of a drastic law 
regulating the sale of habit-forming drugs in 
New York State, but because of severe pres- 
sure brought by physicians and druggists I 
was unable to put it through. In 1914, I tried 
again, and after a hard fight was able to have 
enacted a bill, which was introduced by Senator 
John J. Boylan, and which bears his name. 
For the first time there was then put upon 
the statute books of the State real restrictive 
drug legislation. 

I predict that it is only a matter of time 
before public sentiment will cause prohibitive 
legislation to be enacted, and that the country 
will be largely freed from the illegal habit- 
forming drug traffic. 

Of course, until there is some international 
understanding between the countries that pro- 
duce these drugs and the countries that con- 
sume them, we shall have to submit to more 



HOW TO KILL THE SNAKE 185 

or less smuggling of these drugs into the coun- 
try. Smuggled goods, however, rarely, if ever, 
find their way into channels for legitimate 
medical needs. For this reason it is only the 
underworld that would be affected by their use 
or abuse. 

I have known of many cases of drug habit 
which have grown out of the administration 
of morphine for recurring troubles, such as 
renal colic. Such a disorder as this should 
never give rise to a drug habit. Those suf- 
fering from it are subject to such brief periods 
of pain that a physician could administer the 
necessary drug without their knowledge. 

I have also had many cases of women, who, 
acquiring the habit through the administration 
of drugs at the time of their monthly periods, 
became habitual users, altho each recurrence 
of the period lasted only three or four days. 
When this problem is thoroughly understood, 
such evils will be impossible. 

Moreover, I am strongly committed to the 
proposition that a consultation of physicians 
should be held before the administration of 
a narcotic. I have been told that to require 
such consultation before the administration 
of a habit-forming drug would put upon the 
patient a financial burden which he should 
not be asked to bear. 



186 HABITS THAT HANDICAP 

No fallacy could be more complete. There 
is in the United States to-day not one victim of 
the drag habit who, knowing as he does the 
intense suffering it entails, would not rather 
have given up ten years of his life and been 
forced to put a mortgage on his soul than to 
have had this habit fastened on him. The 
cost of a consultation is a small price to pay 
for the possible difference between life-long 
thralldom and free manhood or womanhood. 

It may help us to a better understanding 
of the drug evil to know that drug-takers are 
by no means all alike, and that, taken as a 
whole, they fall into three broad, but well- 
defined, classes. 

First, there are those who are dependent 
upon a drug because of some permanent under- 
lying physical disabilty. They must have the 
drug to alleviate the pain growing out of this 
disability. Patients of this type must continue 
to take the drug as long as they live. 

For these patients, after proper legal iden- 
tification, means should be provided to enable 
them to get the needed drug in a regular, 
legal way, either through their own physi- 
cian's prescription, or else by a prescription 
"franked" by Federal, State, or municipal 
authorities. 

Secondly, there are the individuals who have 



HOW TO KILL THE SNAKE 157 

acquired the drug habit through illness, in 
which the drug has been prescribed regularly 
by a physician, or where they have gone into 
drug stores and bough: openly and legally 

:-r the counters preparations and ''rerne- 
ntaiuing certain minimum quantities 
of such drugs. 

There may be no longer any real reason 
why these people should continue to use the 
drug. Yet they can not discontinue it without 
definite medical treatment, because the pain 
of deprivation and withdrawal makes such a 

arse practically impossible. To cut these 
people off from their supply arbitrarily would 
be legislatively criminal: to make them resort 
to subterfuge to eet their drus\ little less so. 

Thirdly, and last, we have" the underworld 
type of addict, who has acquired the taking 
of the drug simply through dissipation. Drug- 
taking is a '• social evil" in this class. It is 
a feature of drug-taking that one given to 
the habit is generally ready to set up the same 
habit in another: and this is particularly true 
of the underworld type of addict. 

He. or she, loves company; and among cer- 
tain classes the ;% social' " aspect of the habit 
assumes the form of an orgy, such as •'cocaine 
party/ ' 



188 HABITS THAT HANDICAP 

This class, of course, knows nothing of laws 
whatsoever in getting its supply, and will al- 
ways be able to get it — until the "drug evil" 
is cut off at its source by international agree- 
ment, operating through some form of world- 
wide standardized or cooperative international 
anti-habit-forming drug law. 

For it has been demonstrated to be quite 
practicable for all the opium producing coun- 
tries to make the drug traffic a government 
monoply. It would be equally practicable for 
them to sell directly to those governments 
that use it for governmental distribution. 

The only obstacle to an international under- 
standing of this kind is that the producing 
countries know very well that government reg- 
ulation would materially lessen the sale of the 
drug, and consequently would interfere with 
their profits. 

In addition to all those who have acquired 
the drug habit through illness or injury, there 
is an army of drug-takers who first became 
habitues through taking certain druggists ' 
preparations that contain minimum quantities 
of these drugs, sold freely over the counters. 
Under the present law these are excepted 
from any but practically nominal control or 
regulation. 



HOW TO KILL THE SNAKE 189 

There are now about twenty-five hundred 
such preparations in the United States, and 
there might just as well be ten thousand, for 
they would still be within the law as it now 
stands. Any one of these preparations will 
eventually set up a drug tolerance. And in 
the end the people who take them are just as 
likely to establish a drug habit as if they were 
taking such drugs in any other way, even 
hypodermically. 

But the people are now waking up to the 
immoral enormity of this whole drug situa- 
tion and are beginning to realize the social 
waste and economic loss that it involves. It 
will not be long before public opinion is clearly 
crystallized, and will compel the authorities 
to undertake and put through a number of 
restrictions which, more than six years ago, 
I urged upon the medical and pharmaceutical 
professions of the State of New York. So I 
believe it perfectly feasible to kill the snake 
we have only scotched, if we could insure: 

First, that no prescription be filled, or any 
preparation sold, that contains habit-forming 
drugs, except on the prescription of a physi- 
cian, dentist, or veterinarian regularly licensed 
to practise. 

Second, that every prescription be made in 
triplicate. 



190 HABITS THAT HANDICAP 

Third, that no prescription be filled more 
than ten days after date; that the name and 
address of the purchaser and the pharmacist 
be entered in duplicate in an official record 
furnished by the Local Health Board. 

Fourth, that no prescription shall call for 
a quantity to suffice longer than three weeks. 

Fifth, that separate quarters be provided 
in county and city hospitals for drug-addicts, 
and that the local health authority shall fur- 
nish to any addict, without charge, a prescrip- 
tion for drugs as deemed necessary by a 
Medical Health Office, the Health Commis- 
sioner's discretion being final in the matter. 

And bear in mind always, that "pitiless 
publicity 7 ' is one of the most powerful of all 
the weapons we can employ against the venal 
poison vendor. The great, sane public can, 
almost invariably, be trusted to act expedi- 
tiously and with judgment when it is in pos- 
session of all the facts. If informed, it will 
not long tolerate iniquity. 

Therefore, if without dejay there could be 
brought about a preliminary friendly confer- 
ence among all interests concerned in the drug 
habit, — including Government officials, State 
Boards of Health, representatives of the retail 
and wholesale drng trade, and representatives 



HOW TO KILL THE SNAKE 191 

of the medical profession, — with a full public 
discussion of all the various phases of the 
matter, much might be done to expedite the 
solution of the problem. 

With the alcohol question an excellent begin- 
ning has already been made. It is only a 
beginning, however. Much yet remains to be 
done, for there still exist thousands of noxious 
alcoholic substitutes to be drastically dealt 
with. Oceans of the white poison, colored 
pink, or doctored mildly in the way that makes 
it possible, under the present laws, to conduct 
their sale openly, and in direct violation of the 
intent of the prohibitory restriction, are still 
available. 

But reform will come ultimately. We are 
cutting off the dog's tail — a little piece at a 
clip. In the fulness of time we shall have the 
tail that formerly wagged the big American 
dog completely amputated. 

In the meantime, however, the pernicious 
results of our wholesale poisoning by alcohol 
will have to be dealt with. And, as yet, there 
is not much more intelligence exercised in the 
treatment of victims of alcohol in our hos- 
pitals than there was one hundred years ago. 
There is the same lack of classification — the 
same neglect to employ definite medical treat- 



192 HABITS THAT HANDICAP 

ment. The ^ame needless horrors are perpe- 
trated — padded cells, confinement, deprivation. 
The same archaic moral suasion — the same 
"sobering up," and the same penalization for 
the inevitable relapse. 

Nothing is being done, either sociologically 
or medically to rehabilitate these men and 
women. And yet, that they can be rehabili- 
tated, I have proved in thousands of cases — 
to the satisfaction of the most prominent medi- 
cal men in the country. 

Time and again I have published full ac- 
counts of this work. I have begged and 
pleaded with Government and State officials 
to establish hospitals qualified to give this 
definite medical treatment. I have offered to 
cooperate in every possible way in advising 
and instructing in these newer scientific 
methods. 

I have done, and am doing, everything I con- 
sistently can to put the State and National 
authorities in the work of human salvage — 
and put myself out. All because I feel the 
pathos and the pity, the ignorance and the 
stupid, blundering inefficiency of our present 
antiquated and hopelessly inadequate attempts 
to deal with these vital and pressing prob- 
lems. 



HOW TO KILL THE SNAKE 193 

For if alcoholics, as well as drug-addicts, 
were treated as they should be, with definite 
consideration for unpoisoning their pathologi- 
cally saturated tissues, a very large propor- 
tion of the 20 to 30 per cent, of insanity ad- 
mittedly due to alcohol would be prevented. 

If proper remedial measures were adopted 
for eliminating the toxins engendered by alco- 
hol, there need develop very few cases of 
delirium tremens or "wet brain' ' to break 
men's minds. 

For where alcoholics are properly treated — 
with regard to their pathology — they rarely 
develop delirium tremens. Under proper treat- 
ment, few unfavorable mental conditions will 
ever arise. 

So it would merely require intelligent han- 
dling of this subject to close, or radically 
reform, 99 per cent, of all public institutions 
devoted to the care of inebriates; it would 
depopulate one-half the sanitaria between the 
Atlantic and the Pacific. 

Nor need that horrible fear of impending 
insanity, which is frequently the precursor 
of actual insanity, and which is, indeed, one 
of the chief causes of mental unbalance, ever 
again plague a drug, an alcoholic, or a nicotine 
victim, for this morbid apprehension is a 



194 HABITS THAT HANDICAP 

manifestation of a systematic toxic condition 
brought about by means as material as a 
cinder in the eye. 

And as the cinder is removed by everting 
the lid and sweeping out the particle, so is 
the toxin removed by stimulating the cells 
and sweeping out their accumulated poisons. 
And with this cleansing comes' rationality — 
normality. 

And, finally, I am convinced that, for the 
good of humanity and for the welfare of the 
generations that are to come, the hopeless 
victim of alcohol and toxic drugs* should be 
prevented from transmitting his instability. 

The hopeless inebriate should be unsexed, 
not because of the danger that if left sexually 
normal he might transmit his alcoholic ten- 
dencies by heredity to his offspring, but be- 
cause he is a liability at best, and to leave him 
normal adds to his potentiality for waste and 
evil. 

Children born of alcoholic-tainted parentage 
are not specially likely, I think, to yield to 
alcoholic and tobacco tendencies, but they are 
likely to lack vitality and mental stamina, so 
that the probability of their making worthy 
records is small. 

To save alcoholics is vastly less important 



HOW TO KILL THE SNAKE 195 

than to prevent their being born. This prin- 
ciple is being more and more generally recog- 
nized throughout the world. It stands behind 
sanitation and all preventive medicine, and 
will, before long, be recognized in connection 
with the problem of alcohol and drags. Thus 
the battle against addiction will become, as 
the battle agains tuberculosis has become, a 
campaign of education. 

It is all so absurdly simple — so elemental 
■ — so obvious — that even the most patient- 
minded can not be blamed for resenting at 
times the apathy, the indifference, the lack of 
ordinary human intelligence displayed in deal- 
ing with this tremendously vital question of 
toxic addiction. 

And yet, in the fulness of time, the truth 
must prevail. And the world generally must 
accept it. 

With the dawning of that day there will 
come a cleaner, saner, sweeter life to men 
and women. The innocent child will no longer 
cower from the leering face of a demon- 
parent made mad by drugs. The tender- 
minded maiden will be spared the quick blow 
over the heart with the scorpion whip of a 
drunken lover's oath. 

The care-harried mother will be safeguarded 



196 HABITS THAT HANDICAP 

from the pall of an incubus that has covered 
her like a great monster with brooding wings. 

And the slow-flowing blood of years well- 
lived will be warmed in the long winter of a 
kindly, resolute old age. 

If what I have here written, and what I 
have tried sturdily to do in all the best years 
of my life shall be, even in some small 
measure, instrumental in helping to bring this 
about, I shall be well content. 



APPENDIX 



197 



THE EELATION OF ALCOHOL 
TO DISEASE 

BY 

ALEXANDER LAMBERT, M.D. 

President of the American Medical Association; 

Visiting Physician to Bellevue Hospital; Professor of 

Clinical Medicine, Cornell University 

Author of "Hope for the Victims of Narcotics" 

In the simple heading of the subject-matter 
of this article there are contained such possi- 
bilities of facts and fancies, truths and errors, 
and wide differences of opinion, that it seems 
wise to define not only its meaning, but some 
of the words themselves. "What is disease? 
To many people it is a definite, concrete thing 
which seizes one in its clutches, holds one cap- 
tive or possesses one for a short time, and 
then if overcome releases its grip and one is 
free and in good health again. But disease 
is not an entity, even tho some agents, as 
bacteria, are living organisms. It is the lack 
of some processes which these agents* over- 
come, and others which they set in motion, as 
manifested by disturbances of various func- 
tions of different organs in the body that make 
up some of our diseases. Our bodies are often 

199 



200 HABITS THAT HANDICAP 

In a state of delicate equilibrium, and if some 
one gland fails to secrete, or secretes too 
abundantly, the resulting condition may be- 
come a disease. As health is a harmonious 
relationship between the various functions of 
different parts of the body, so disease is a 
disturbance of this harmony. The question 
of the relation of alcohol to disease becomes 
a question as to whether or not this narcotic 
if taken into the body can react on the various 
tissues and organs of the body to such a 
degree as to disturb the equilibrium of health. 
And, furthermore, can this disturbance of 
healthy equilibrium be permanent and the 
body acquire a lasting diseased condition? 

HOW IT AFFECTS DIFFEKENT MEN 

Alcohol is classed here as a narcotic and 
not a stimulant, because we shall see later 
that alcohol is rather a paralyzer of func- 
tions, even when it seems to stimulate, than 
a producer of increased output from any or- 
gan. The time-honored idea that alcohol is a 
stimulant and that, if used in moderation, it 
Is a tonic, is so ingrained in the average mind 
that it is with the greatest difficulty that men 
can be made to realize that even in what 
seems moderate doses it may injure them. 



APPENDIX 201 

This is especially true as one sees men who 
all their lives have indulged moderately in 
alcoholic beverages from which seemingly no 
harm has resulted. The truth, perhaps, is 
best summed up by the old adage that what is 
one man's meat is another man's poison, and 
there is no question that the effects of alcohol 
in small or moderate doses is vastly different 
from its effects in large doses, or in long- 
continued, excessive use. Different human 
beings react differently to similar amounts of 
alcohol, and conversely, identical amounts of 
alcohol will affect different individuals in dif- 
ferent ways, even when it poisons all of them. 
For instance, if alcohol sets different processes 
in motion which bring about damage to the 
individual, we find that in some persons it has 
injured the heart and arteries, in others it has 
affected the liver or stomach, leaving the brain 
and nervous tissues free from damage, while 
in still others the body in general seems to be 
untouched and the brain and nervous tissues 
suffer the injuries. It is not uncommon to see 
a man who has partaken freely of alcoholic 
beverages all his life with neither he nor his 
friends conscious that his intellect has suffered 
or deteriorated thereby, to find suddenly that 
his circulatory and digestive systems are seri- 



202 HABITS THAT HANDICAP 

ously and permanently damaged. On the other 
hand, many a drunkard has become a burden 
to his family and the community, with his 
personality deteriorated, his intellect rendered 
useless, while his circulation and digestion re- 
main unimpaired, and he lives long years a 
nuisance and a burden to his environment. 

Since I have made the distinction between 
moderation and excess in the use of alcohol, 
it will be well to define what is regarded as 
excess, and what moderation, in order that the 
effects of both may be considered. Physio- 
logic excess, it seems to me, has been best 
defined by a brilliant Frenchman named Du- 
claux, who says that any one has drunken 
alcohol to excess who one hour after he has 
taken it is conscious in any way of having 
done so. If after a drink of any alcoholic 
beverage has been taken, wine, whisky, or 
whatever it may be, an hour later we feel our- 
selves flushed, tongue loosened, or if we are 
heavy and drowsy or, if we find our natural 
reserve slightly in abeyance, if the judgment 
is not as sternly accurate as before partaking 
of the beverage, if the imagination is unusu- 
ally active and close consecutive reasoning not 
as easy as before, if we think we do our work 
much better, but next morning realize we 



APPENDIX 203 

haven't accomplished quite as much or done 
it as well as we expected, then we have shown 
a physiologic excessive intake of alcohol, and 
an amount which if continued will produce 
damage somewhere in the body. Moderation 
in the use of alcohol means that it be taken 
in amounts of which one remains unconscious. 
This may seem a narrow and hard line to 
draw, and may seem to confine the amount of 
alcohol that may be consumed to much less 
than many people wish to indulge in. How 
much in actual amount this should be with 
any given individual depends upon that indi- 
vidual alone, and no one can be a law to any 
other individual than himself. If a man be 
engaged in severe manual labor or muscular 
exercise, he can consume more alcohol without 
detriment than when leading a sedentary life, 
altho the character of the work that he will 
do may not be as good as if no alcohol were 
taken. 

THE MODEKATE USE OF ALCOHOL 

The above definition, however, must suffice. 
We must fix some standard between modera- 
tion and excess, and the more accurately we 
define moderation, the more narrowly do we 
confine it. Judged by the above standard, al- 



204 HABITS THAT HANDICAP 

cohol taken in moderate doses does not seem 
more than to stimulate the digestive processes 
of the stomach, increase the flow of blood 
through the heart, increase the circulation in 
the periphery and skin, dilate the capillaries, 
and make it easier for the circulation to com- 
plete its cycles. When absorbed into the body 
in such doses, it can act as a food, and, in 
fact, as much as is burned up by the body does 
act as a food, altho it differs from other foods 
in that it is never stored up. It can replace 
in energy-giving properties sugars or fats, 
and being burned up by the body can give out 
the equivalent of sugar and fat in muscular 
energy, and heat generated and given out by 
the body. Its effect is similar to that obtained 
by sugar and fats which are taken up by the 
body when needed and in the amounts requisite 
to the body at the moment, and it seems to be 
treated as far as can be seen as other foods 
for fuel. But it is not an economical fuel, 
because the human organism does not perform 
its work as well as when there is no alcohol 
in the ration. Simultaneously, when being 
consumed as food, it is exerting its drug ac- 
tion. In this process it is the more easily 
available, and thus the sugar and fats are 
stored up while the alcohol is burned up; it 



APPENDIX 205 

spares the fat consumption, often causing an 
increase of bodily weight through the putting 
on of fat. To those who are accustomed to its 
use, it seems also to spare the protein con- 
sumption of the body, but to those unaccus- 
tomed to its use it has the opposite effect, in- 
creasing the destructive breaking down of 
proteins. 

Danger Signals Unheeded 
Moderate indulgence in alcoholic beverages 
adds to the pleasures of existence with a great 
many men, and while it seems to increase their 
pleasures and broaden the extent of their men- 
tal experiences, it can not be said to increase 
their powers of accurate mental activity, tho 
it temporarily increases the imaginative flow 
of ideas. It relieves the feeling of both body 
and mental fatigue for the time being, an 
effect which may be an advantage or may be a 
distinct disadvantage, for fatigue is Nature's 
warning when to stop, and if we dull ourselves 
to this feeling and leave the warning unheeded, 
we may easily go on to harmful excesses of 
overwork and over-exertion. It is doubtful 
if the moderate drinking of alcohol, as we 
have defined moderation, sets in motion proc- 
esses which may so disturb the equilibrium of 
the body as to cause disease. 



20G HABITS THAT HANDICAP 

Broadly speaking, the excessive use of alco- 
hol injuries the body in two ways. It injures 
the functional cells of the different organs, for 
alcohol is distinctly a cellular poison, and it 
further disturbs the nutrition of the organs 
by its injurious action on the blood-vessels 
which supply nutrition to the various parts of 
the body. Whether to replace the destroyed 
cells or as a result of the congestion, there is 
also an increase in the connective tissue frame- 
work of the various organs. The action of 
alcohol on the circulation is one of the earli- 
est effects which is shown after it is taken 
into the body. The flushing of the skin is a 
beginning paralysis of the minute capillary 
blood-vessels. If habitually indulged in, the 
effect is a continuous dilatation of the vessels, 
altho it seems for a while in the early stages 
that there is a toning up of the circulation. 
Yet excessive indulgence brings with it always 
a lowering of the blood pressure and finally 
the chronic congestions in the internal vis- 
cera. The action of the heart at first is to 
make it beat fuller and stronger, but if con- 
tinued, the effect is also one of paralysis of its 
muscle and a diminution of the output of 
work done, and finally it is a paralyzer of the 
heart's action. In some persons, through its 



APPENDIX 207 

injury to the cardiac blood-vessels and in- 
trinsic muscle of the heart, it sets in motion 
those morbid processes which result in angina 
pectoris. 

Beginning with the stomach, we find that 
when alcohol is taken in excess it not only dis- 
turbs the processes of digestion that are then 
going on, if it is taken in greater amount than 
5 per cent, of the stomach content, but it also 
acts directly on the mucous membrane, pro- 
ducing an irritant action. "We have formed 
here a chronic congestion of the mucous mem- 
brane which produces swollen cells, and the 
digestive glands of the stomach produce an ex- 
cess of mucus which interferes with digestion, 
and the resulting congestion interferes with the 
gastric secretions. It ends in producing a 
swollen, inflamed mucous membrane, often with 
hemorrhages. These processes may go on to 
an atrophic form of gastritis, in which the 
mucous membrane may be so atrophied that 
it is unable to secrete sufficient gastric juice. 
The acid of the gastric juice, combining with 
certain substances in the intestine, is one of 
the stimulants which causes the production of 
the pancreatic secretion. The pancreas not 
alone digests the meats and other proteids, 
but it changes starch into sugar, and also has 



208 HABITS THAT HANDICAP 

a fat-splitting ferment. Thus we see that 
pancreatic digestion is a most important func- 
tion, and does much more in the digestive work 
than the stomach. When, therefore, the acids 
of the gastric juice are lacking, there is an 
insufficient stimulus to the pancreas:- to pour 
out its complex juices and complete digestion; 

THE ATTACK TTP0ST THE LIVER 

Alcohol is so rapidly absorbed from the 
stomach and the upper intestine, that it does 
not as a rule produce much change in the small 
intestines. The absorption of the digested food 
from the intestinal tract by alcoholics when 
recovering from a debauch is greater than 
normal, provided they have ceased from their 
alcohol. The absorbing powers of the in- 
testine remain a long time, and is the reason 
that so many alcoholics appear so well nour- 
ished. The acids of the gastric juice also 
stimulate the excretion of bile from the liver, 
and, combining with the same ferment, the 
secretion, being taken up by the blood, stimu- 
lates the liver to an increased secretion of 
bile. If, therefore, one has so injured the 
stomach with the taking of alcohol that the 
mucous membrane is unable to secrete a 
proper gastric juice, it is readily seen that 



APPENDIX 209 

the proper stimulation to the liver and the 
pancreas are lacking and the equilibrium of 
the entire digestive process of the body is 
upset. The blood from all the intestines goes 
directly to the liver, the circulation of this 
organ being so arranged that the blood must 
filter through and bathe the liver cells before 
it is gathered into a central vein and returns 
into the general circulation. In fact the liver 
is the great chemical laboratory of the body, 
and the complex processes that go on there 
are as yet but little understood. The processes 
which I have described as generally character- 
istic of alcohol are seen to a very marked ex- 
tent in the liver. There is a chronic conges- 
tion, and there is very frequently various 
forms of degeneration in the hepatic cells, and 
in many cases an increase in the connective 
tissue to such an extent as to cause the dis- 
ease known as cirrhosis of the liver. 

Alcohol may also under certain circum- 
stances produce such excessive fatty degenera- 
tion in the liver as in itself to be a menace 
to existence, for if the liver ceases to do its 
proper work the whole minute nutritive chem- 
istry, the metabolism of the body, breaks to 
pieces. The liver stands* an enormous amount 
of use and abuse, and it is one of the last 



210 HABITS THAT HANDICAP 

organs to give way under great strain, but 
when its function processes do break down, 
the existence of the individual is not much 
further prolonged. The liver can consume 
and break down a certain amount of alcohol, 
but when more is poured into it than it can 
assimilate, some of it must go through into 
the general circulation and over the body, 
flowing to the brain and poisoning this organ 
and the other nervous tissues. 

The action of alcohol on the nervous tissues 
constitutes, in the eyes of the majority, the 
main injury that alcohol does to a human be- 
ing. Certain it is that the action of alcohol 
on the brain does more to distort and per- 
vert a man's relationship with his environ- 
ment than any other action which alcohol has 
on the body. It is through the poison of this 
organ that the personality of the individual is 
so changed and so poisoned that a degenera- 
tion of the individual in character and morals 
is brought about. It is here, too, that the wid- 
est differences of tolerance and intolerance to 
alcohol are shown. Some men may consume 
enormous quantities, and their mental balance 
apparently remain intact. Other individuals 
can not take a single glass of wine without 
being distinctly affected by it, or rendered 



APPENDIX 211 

unmistakably drunken. The gross injuries 
found in the brain of those dying from the 
effects of alcohol are partly due to the effect 
of alcohol on the circulation and the injury 
to the blood vessels, thus diminishing the 
nutrition of the brain and injuring the brain 
tissue itself, and besides, as we have seen in 
other viscera, to the increase in connective 
tissue. 

It is not necessary here to go into the de- 
tails of the minute formation of the cells, 
how each cell is formed of a cell body and 
many branches, as one may conceive, growing 
like a tree or bush with the many branches 
stretching out and touching other branches of 
related and adjacent cells. When these den- 
drites or branches are in contact, there is an 
interrelationship between the processes of the 
two cells. Alcohol causes a retraction of the 
tiny branches one from another and the cells 
are dissociated, so that the mental processes 
become dissociated from each other and the 
cells themselves degenerate and are unable to 
carry on their functions; thus we see the 
functions of memory and of the reproduction 
of images by memory prevented, the inability 
of the mind to reason, through the inability 
of the mind to call up former experiences, 



212 HABITS THAT HANDICAP 

feelings and ideas, and a weakening of the 
power of each cell to take in impressions. 

Every person who drinks alcohol to excess 
will not show every form of mental deteriora- 
tion that may be produced by excessive indul- 
gence, and the degree of deterioration in in- 
telligence which goes to make up the sum total 
of mentality varies greatly in different indi- 
viduals. All who drink alcohol to excess, how- 
ever, show some diminution in their judgment. 
Judgment means the power of recalling vari- 
ous memories of perceptions through the 
senses, which have come in from the outside 
world, memories of ideas, memories of emo- 
tions, and all the complicated association of 
ideas that these bring up, and in the recalling 
of them weigh each one with the other and 
judge the value between them. This- also means 
reasoning and decision for action. This power 
of reasoning and judging is weakened in 
the alcoholic, and in any brain long poisoned 
by alcohol it is an impossibility to exercise it. 
Memory itself is also weakened. There is ex- 
cessive forgetfulness of the recent past, and 
in some cases of advanced alcoholism there is 
absolute forgetfulness of wide gaps of years; 
a man may be unable to remember anything 
from the last five minutes 'back for twenty 



APPENDIX 213 

years, and then remember back to childhood. 
The memories of childhood are more easily 
stamped on the brain than are those of adult 
life, both because it takes less to impress a 
child, and because there is not the complexity 
of ideas crowding into the brain, nor the 
complexity of association of ideas to be re- 
corded. Therefore, memories of childhood 
make a deeper impress and last longer, and 
so the complex memories of the adult are the 
first to be forgotten in the alcoholic, and those 
of childhood remain. 

EFFECT UPON MEMORY AND JUDGMENT 

Besides the absolute forgetfulness, there is 
another form of forgetfulness in the alcoholic 
which often produces a ludicrous result. This 
is a perversion of memory. The person may 
be in a perfectly strange place and meet 
strangers, and yet be convinced that he has 
seen the place and met the strangers before, 
and greet them as old friends. This feeling 
of having been there before occurs- in normal, 
healthy people, and may be simply the ex- 
pression of momentary fatigue, or proceed 
from some unknown cause, but it is grossly 
exaggerated in the alcoholic, and can not as 



214 HABITS THAT HANDICAP 

easily be straightened out as in the normal 
mind. 

The imaginative faculties of the mind are 
at first heightened by alcohol, and this often 
produces bright, witty remarks in those who 
have taken enough alcohol to have their imag- 
inations stimulated and their judgment slightly 
inhibited, so that their ideas crowd readily 
to their minds and their tongues are loosened. 
Often, however, they say things which, tho 
bright and witty, had better be left unsaid, 
and this is an indication of the beginning 
paralysis of their judgment. The imaginative 
faculties, however, are not constructively in- 
creased by alcohol, and it does not conduce 
to reproduction and creative ability, which 
requires memory and constructive thought. 
In this connection Kraeplin's experiments 
have shown that alcohol makes easy the libera- 
tion of movements from the cortical areas of 
the brain — that is, the transformation of ideas 
and memories of movements into deeds, but 
no real mental power is given, for while a 
man may feel that he is doing things better 
with than without alcohol, as a matter of fact 
he. is not doing them so well. This sense of 
self-approbation is very characteristic of the 
alcoholic. His judgment is gone, not only in 



APPENDIX 215 

regard to his mental processes, but very essen- 
tially regarding himself, and it may be truly 
said that while alcohol shrinks the judgment, 
it swells the self-conceit. This abnormally 
good opinion of his diminished abilities ren- 
ders the alcoholic exceedingly complacent; he 
is persuaded that at any time he can give up 
drinking if he chooses, and he is unable to 
appreciate the rapid deterioration of his in- 
tellect. One can not separate the will of an 
individual from his personality, and the weak- 
willed individuals, while they may possess 
many other agreeable characteristics, are lack- 
ing in the progressive force which strong 
characters possess. Alcohol weakens the will, 
causes the personality itself to deteriorate, 
and there is a lack of initiative; there is the 
ever-ready specious explanation why nothing 
is ever done; there is a boastful, conceited 
estimation of what can be done. With the 
judgment perverted the alcoholic can not act 
at the proper time in the right way, no matter 
how much he may be willing to admit the 
necessity for correct action, and on the other 
hand he is equally powerless to prevent wrong 
action on his part, especially when such ac- 
tion has anything to do with a further indul- 
gence in his alcohol. 



216 HABITS THAT HANDICAP 

The emotional side of the personality shows 
the same deterioration from the higher to the 
lower, as do the other intellectual processes. 
It is the same story that the last to come are 
the first to go, and the first to come are the 
last to go. All emotions of refinement, those 
of the esthetic development, disappear the 
earliest. The sense of affection and moral 
responsibility, duty to family and friends 
deteriorate and vanish. There is nothing left 
but the consideration of what affects the self, 
and an alcoholic is the most studied, selfish 
soul that exists. The remaining emotions of 
anger, fear and nutritional reaction for food 
and drink remain to the last, as these are the 
most primitive of the emotions. With the 
weak will preventing action, and with the loss 
of memory and inability for continuity of 
thought, we find the emotion of fear predom- 
inating to a very noticeable extent. This is 
true whether the alcoholic be delirious or not, 
for in all forms of alcoholic delirium, fear is 
a very predominant symptom. In some forms 
of delirium tremens, the intensity of the fear 
is a fair criterion of the degree of the poison- 
ing. The various senses of sight, hearing and 
taste are dulled, because the cells producing 
the mental perceptions are equally poisoned 
with the rest of the mird. 



APPENDIX 217 

WEAKENING THE MOKAL EIBEB 

With the inaccuracy of sense perception and 
loss of memory and diminished judgment, one 
can not be surprized to find that alcoholics are 
notoriously inaccurate, unreliable and untruth- 
ful. They can not tell the truth even with as- 
sistance. But often what is credited to them 
as untruthfulness is mere inability to perceive 
things accurately, to remember accurately, and 
therefore to state things accurately. "With the 
deterioration of the personality, that is, of 
the will, one would naturally expect that the 
deterioration of morals would go hand in 
hand. One can not remain moral or virtuous 
without sufficient will to do so, and without 
sufficient will to make a struggle for self- 
control, and this is so in the case of a mind 
poisoned by alcohol. I do not claim that lack 
of morals is a disease, but moral development 
has appeared late in the development of the 
race, and such racial development is exprest 
by the individual. With the deteriorated men- 
tality of the alcoholic, we must expect that 
the characteristics of late development will be 
the first to go, and for this reason we must 
realize that alcoholism naturally tends to im- 
morality and crime. As a matter of fact, it 



218 HABITS THAT HANDICAP 

is claimed that 50 per cent, of the crimes in 
France and 41 per cent, in Germany are due 
to alcoholism, and no doubt in England and 
America the percentage is equally high. As 
might be expected, the offenses are principally 
those of disregard of the rights of others, 
contempt of law and order, assault, disturb- 
ances of domestic peace and robbery, and to 
all these crimes the habitual drunkard is par- 
ticularly prone. 

But it is not my purpose to discuss the 
effect of alcohol in any way, except as it 
pertains to the human body, nor to go into the 
reasons why men so poison their bodies as to 
bring about these deleterious results. The 
deterioration that we have been considering, 
when occurring in the mind, would naturally 
cause one to infer that insanity must also be 
common in those who are addicted to alcohol, 
and such is indeed the case. In New York 
State alone I believe it can be safely said 
that fully 10 per cent, of the women and 30 
per cent, of the men confined in the State 
asylums are there through forms of insanity 
caused by alcohol. It will not profit us to go 
into the various forms of alcoholic insanity, 
but when we realize that one-third of the men 
in the insane asylums to-day in New York 



APPENDIX 219 

are there because of excessive indulgence in 
alcohol, and also that the State spends annu- 
ally over six million dollars to care for them, 
we realize both the terrible ravages that alco- 
holic poison has made on the mentality of men 
and the enormous cost that it entails upon 
the community. 

As to the alcohol circulating in the blood, 
there is an endeavor naturally to get rid of it 
as with all poisons, and the kidneys in this 
endeavor show the same processes that are 
elsewhere seen, of destruction of the specific 
cells, congestion, and increased connective tis- 
sue growth. Whether it is that these cells 
are destroyed in an endeavor to eliminate 
various substances for which they are not 
fitted and break down under the strain, or 
whether they are directly poisoned by the 
alcohol itself, the resultant factors are those 
best understood in the lay mind as acute and 
chronic Bright 's disease. Whether or not 
alcohol produces these various processes in 
the kidneys which result in these diseased 
conditions, there is no question but that cer- 
tain of these diseased conditions appear more 
frequently in alcoholics than in others. Be- 
sides the destructive processes about which 
we have been speaking in the various viscera, 



220 HABITS THAT HANDICAP 

there are certain results of alcohol that may 
be said to affect the general condition of 
the individual. By this I mean the general 
resistance to bacterial infection, the resistance 
to injury to the body, and the ability to repair 
such injuries. Alcohol diminishes the power 
of the body to resist bacterial infection. The 
alcoholic is more prone to acquire bacterial 
diseases, and when these are acquired he is 
infinitely less able to resist them. In Bellevue 
Hospital in 1904 there were 1,001 patients 
with lobar pneumonia. Of these 667 gave a 
history of alcoholism; 334 were non-alcoholics, 
which means that there were twice as many 
alcoholics suffering from this disease as non- 
alcoholics. Among the alcoholics the mortal- 
ity was 50 per cent., and among the non- 
alcoholics 23.9 per cent. Here again the mor- 
tality among the alcoholics was more than 
double that which prevailed among those who 
had not taken this narcotic. The same is true 
of other infectious diseases. "When injuries 
occur to the body, such as broken legs or 
arms, there is a very wide difference in the 
picture produced in those who have drunk to 
excess and those who have been sober. The 
shock produced in these instances is greater 
in the weakened nervous system of the alco- 



APPENDIX 221 

holic, and among those who have habitually 
taken alcohol there is a very great tendency 
after broken bones to develop delirium trem- 
ens, and when this occurs in these patients, 
the outlook is always very grave. A broken 
leg or arm does not bring with it any such 
danger to those who have led sober lives. 
The process of recovery from disease and acci- 
dent, owing to the deteriorated nervous sys- 
tem and the poisoned circulatory system, is 
much slower in alcoholics than in others. 

WEAK WILLS IKHEKITED 

Unfortunately, the injury which alcohol does 
and the processes of deterioration which it 
sets on foot do not end with the individual. 
Alcohol poisons and injures the germ-cells of 
both sexes, and the offspring of those addicted 
to its use may inherit a weakened and injured 
nervous system. The taste for alcohol, the 
craving, so called, is not inherited. This idea 
that, because a man has an alcoholic father 
or mother, he inherits the taste for alcohol is 
a superstition that has been used by the weak 
as an excuse both for overindulgence in alco- 
hol, and as a further excuse why no attempt 
should be made to check their indulgence. 
What is inherited is a weak, unstable intellect 



222 HABITS THAT HANDICAP 

and personality, prone to excesses in all things, 
one that is weak-willed and weak in resistance 
to temptation, «and one more easily affected by 
alcohol than the ordinary normal individual. 
There is also often inherited a lack of moral 
perception and moral sense, causing the indi- 
vidual to do things which make one doubt his 
sanity; yet he can not be called insane, but 
really wanders on the border line between mad 
and bad, which is often worse than insanity 
itself. Alcoholic inheritance does not stop at 
instability of the nervous system or weak- 
ness of the personality, and one is rather stag- 
gered, to realize the high percentage of im- 
becile, epileptic and weak-minded children that 
may be born to alcoholic parents. A detailed 
study of the imbecile school-children through- 
out all Switzerland showed that 50 per cent, 
of them were born in the days nine months 
after the periods of greatest alcoholic indul- 
gence, such as the New Year, the Carnival, 
and the grape harvest, and that the births of 
the other half of the imbeciles were evenly 
scattered through the remaining thirty-eight 
weeks of the year. It has been shown that 
in France, Germany, Poland and Switzerland, 
from 28 to 70 per cent, of the epileptics in 
some of the institutions were the descendants 



APPENDIX 223 

of alcoholics. Demme, in comparing the re- 
sults of the health- and death-rates between 
ten alcoholic families and ten non-alcoholic 
families, found that in the alcoholic families 
out of fifty-seven children, twenty-five were 
still-born or died in the first month of life; 
twenty-tw T o were designated as sick, and ten 
as healthy — while in the non-alcoholic families, 
five were still-born or died early, six were 
sick, and fifty were healthy. Thus only 17.5 
per cent, in the alcoholic families were healthy, 
while 82 per cent, in the non-alcoholic families 
were healthy, and only 18 per cent, not 
healthy. The percentages, therefore, were al- 
most exactly reversed. These statistics mean 
that not alone may the chronic alcoholic be- 
queath his poisoned nervous system to pos- 
terity, but from the statistics in Switzerland 
of the imbecile children, we must realize that 
even a temporary debauch may leave a curse 
upon the innocent child; they also mean that 
alcohol produces those processes in the indi- 
vidual which tend to the degeneration of the 
race, and tend after a few generations to 
extinction, and thus does Nature benefit the 
race by turning a curse into a blessing through 
the extinction of the degenerate. 



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